Abstract：Objective To define cut-off values of plasma amino-terminal pro-B-type natriuretic peptide (NT-ProBNP) for the diagnosis of congenital heart failure (CHF) and evaluate the importance of plasma NT-ProBNP measurement in the assessment of cardiac function prior to heart surgery in infants with congenital heart disease (CHD). Methods Plasma levels of NT-proBNP were measured in 120 infants with CHD before heart surgery and in 100 age-matched healthy infants between June 2010 and June 2013. The data were stratified based on the presence or absence of CHF in the whole group of CHD infants and on age (i.e., <1 year and ≥1 year) and time (i.e., before surgery) within the subgroup of CHF infants. Results Of the 120 infants with CHD, 41 met the criteria for CHF defined in the Ross Classification for Heart Failure in Infants.The cut-off values of plasma NT-ProBNP were ≥498 ng/L for infants of all ages, 557 ng/L for <1 year age group and 452 ng/L for ≥1 year age group, respectively, in the 41 CHF patients. In CHF infants, plasma NT-proBNP was significantly decreased after protecting of cardiac function (P<0.001). Conclusions The cut-off values of plasma NT-ProBNP for CHF differ between infants <1 year and infants ≥1 year. Moreover, plasma NT-ProBNP can be used as an additional parameter in the preoperative assessment of cardiac function in CHD infants.
LIN Chun-Wang,ZENG Xiang-Lin,MENG Xiu-Hui et al. Clinical importance of preoperative measurement of plasma amino-terminal pro-B-type natriuretic peptide in infants with congenital heart disease[J]. CJCP, 2014, 16(1): 40-43.
Laer S, Mir TS, Behn F, et al. Carvedilol therapy in pediatric patients with congestive heart failure:a study investigating clinical and pharmacokinetic parameters[J]. Am Heart J, 2002, 143(5): 916-922.
[3]
Sugimoto M, Manabe H, Nakau K, et al. The role of N-terminal pro-B-type natriuretic peptide in the diagnosis of congestive heart failure in children[J]. Circ J, 2010, 74(5): 998-1005.
[4]
de Filippi CR, de Lemos JA, Tkaczuk AT, et al. Physical activity, change in biomarkers of myocardial stress and injury, and subsequent heart failure risk in older adults[J]. J Am Coll Cardiol, 2012, 60(24): 2539-2547.
[5]
Rusconi PG, Ludwig DA, Ratnasamy C, et al. Serial measurements of serum NT-proBNP as markers of left ventricular systolic function and remodeling in children with heart failure[J]. Am Heart J, 2010, 160(4): 776-783.
[6]
Connolly D, Rutkowski M, Auslender M, et al. The New York university pediatric heart failure index: a new method of quantifying chronic heart failure severity in children[J]. J Pediatr, 2001, 138(5): 644-648.
[7]
Saunders M, Gorelick MH. Nelson textbook of pediatrics[M]. 19th ed. Philadelphia: Saunders Elsevier, 2011: 280.
Reithmann C, Reber D, Kozlik-Feldmann R, et al. A post receptor defect of adenylyl cyclase in severely failing myocardium from chidren with congenital heart disease[J]. Eur J Pharmacol, 1997, 330: 79-86.
