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Clinical Significance of Changes of Plasma N-Terminal Pro-Brain Natriuretic Peptide in Children with Congenital Heart Disease Combined with Heart Failure

LI Xiong1,YANG Ming-yu1,QIN Jing-ting1,ZHANG Li-fei2,LIN Yi3,WANG Dan1,WANG Chang-ying1(1.Department of Pediatrics,the Affiliated Hospital of Guilin Medical University,Guilin 541001,Guangxi Zhuang Autonomous Region,China;2.Department of Heart Thoracic Surgery,the Affiliated Hospital of Guilin Medical University,Guilin 541001,Guangxi Zhuang Autonomous Region,China;3.Department of Ultrasound,the Affiliated Hospital of Guilin Medical University,Guilin 541001,Guangxi Zhuang Autonomous Region,China)  
Objective To observe the changes of plasma N-terminal pro-brain natriuretic peptide(NT-proBNP) in children with congenital heart disease(CHD) combined with heart failure(HF),and analyze the relationship between the severity of HF and NT-proBNP levels,and explore its clinical significance in the diagnosis of HF and cardiac function classification.Methods Forty-six patients with CHD and HF in the Affiliated Hospital of Guilin Medical University were collected randomly from Jun.2008 to Jun.2011,and they were divided into 3 groups according to the evaluation criteria of New York University Pediatric Heart Failure Index(NYU PHFI):non-HF group(15 patients),mild HF group(16 patients) and moderate to severe HF group(15 patients).Twenty-five healthy children were selected as the healthy control group.Blood samples of all groups were collected.Concentration of plasma NT-proBNP was determined by enzyme-linked immunosorbent assay.The left ventricular ejection fraction(LVEF) and the ratio of early-diastolic peak flow velocity and late-diastolic peak flow velocity(E/A) were determined.The relationships between plasma NT-proBNP levels and modified Ross score and echocardiographic cardiac functional indexes were analyzed.Results Plasma NT-proBNP was positively correlated with the severity of HF(r=0.82,P0.01),the more serious the HF was,the higher the plasma NT-proBNP concentration.Plasma NT-proBNP level in moderate to severe HF group was significantly higher than that in mild HF group(P0.01),plasma NT-proBNP level in mild HF group was higher than that in non-HF group(P0.01),and plasma NT-proBNP level in non-HF group was significantly higher than that in healthy control group(P0.01).Plasma NT-proBNP level was negatively correlated with LVEF(r=-1.20,P0.01).Conclusions Plasma NT-proBNP concentration will elevate with the increase of the serious degree of HF,which indicates that the test of plasma NT-proBNP will be of significant clinical significance in assessing the disease severity and prognosis of the CHD children combined with HF.
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