Aminoterminal Pro B-Type Natriuretic Peptide (NT-proBNP) Levels for Monitoring Interventions in Paediatric Cardiac Patients with Stenotic Lesions

Abstract

Background. Serum concentration of NT-proBNP correlates well with the severity of cardiac disease in adults. Few studies have been performed on the applicability of NT-proBNP for monitoring children with congenital heart disease. Objective. To assess the potential of NT-proBNP for monitoring the success of interventions in children with stenotic cardiac lesions. Methods. NT-proBNP was measured in 42 children aged 1 day to 17 years (y) before and 6 to 12 weeks after surgical or interventional correction of obstructive lesions of the heart. Comparison is made with the clinical status and echocardiographic data of the child. Results. NT-proBNP levels (median 280, range 10–263,000 pg/mL) were above the reference value in all but 6 patients (pts) prior to the intervention. Higher levels were found in more compromised patients. The 35 children with clinical improvement after the procedure showed a decline of their NT-proBNP level in all but 4 patients, whose levels remained unchanged. Five patients with unchanged gradients despite a therapeutic intervention also demonstrated unchanged NT-proBNP levels after the intervention. Thus, the success rate of the procedure correlated well to clinical and echocardiographic findings. Conclusion. NT-proBNP can be used to assess the efficiency of an intervention.

Preoperative NT-proBNP values in patients with atrioventricular septal defect and its role as a predictor of early postoperative course

“…Our result support the fi ndings of Kunii et al (4) of higher BNP levels in patients with ventricular septal defect than in patients with atrial septal defect with comparable pulmonary-to-systemic blood fl ow ratio (without statistical analysis reported). From other associated lesion, right-or left-sided outfl ow tract obstruction was also found as a factor of elevated NT-proBNP levels (11,12). In our cohort of patients, the obstruction of outfl ow tract was present in six of them, and also this anatomical fi nding may play role in elevated values.…”

Korelasi Kadar NT- proBNP dengan Fungsi Fraksi Ejeksi Ventrikel Kiri pada Gagal Jantung Anak

“…Hormon brain natriuretic peptide (BNP) adalah hormon yang dihasilkan oleh kardiomiosit sebagai respon terhadap peningkatan tekanan dinding ventrikel akibat pressure dan volume overload untuk melindungi sistem kardiovaskular. 3,[12][13][14] Pelepasan hormon ini dipicu oleh nor-epineprin, endotelin-1, vasopresin dan arginin. BNP di sintesa dari 108 asam amino dalam bentuk pro hormon (pro BNP) yang kemudian dipecah oleh enzyim proteolitik yaitu corin menjadi bentuk aktif (BNP,77-108 asam amino) dan bentuk tidak aktif NT-proBNP (1-76 asam amino).…”