Cardiac Biomarkers Associated With Hospital Length of Stay After Pediatric Congenital Heart Surgery

Green, Michael D.; Parker, Devin M.; Jacobs, Marshall L.; Jacobs, Jeffrey P.; Brown, Jeremiah R.

doi:10.1016/j.athoracsur.2020.06.059

Cited by 10 publications

(11 citation statements)

References 23 publications

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“…N-terminal pro b-type natriuretic peptide (NT-proBNP) is an inactive amino acid fragment of the brain natriuretic peptide (BNP) that is released from cardiomyocytes in response to pressure or volume overload, promoting vasodilation and natriuresis ( 10 ). NT-proBNP level is associated with impaired cardiac function among children and infants and influenced by kidney function ( 11 – 13 ). In adults, NT-proBNP has been extensively studied in many domains including cardiac diseases, diabetes, and rheumatoid arthritis ( 10 , 14 ).…”

Section: Introductionmentioning

confidence: 99%

Association Between NT-proBNP and Prolonged Length of Stay in Hospital Among Preterm Infants Born at 28–31 Weeks' Gestation

Luo

Lei

et al. 2022

Front. Pediatr.

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ObjectiveIn the early life of preterm infants, the relationship between heart function and length of hospitalization is unclear. This study aims to examine the association between serum NT-proBNP level on the 7th day (NT-proBNP7) after birth and length of hospitalization among preterm infants.MethodsA retrospective cohort study was conducted. Patients included 709 preterm infants born at 28–31 weeks' gestational age (GA) admitted to the NICU of the First Affiliated Hospital of Zhengzhou University between December 20, 2016, to April 31, 2021. Main outcome: Late discharge (postmenstrual age at discharge was in the fourth quartile (highest) among infants born at the same GA). Exposure factor: NT-proBNP7.ResultsWe observed increased prevalence ratios for late discharge among the tertile of logarithm of NT-proBNP7 level (LnNT-proBNP7) which was positive. Compared with the lowest tertile, infants in the highest tertile of LnNT-proBNP7 had an 8.4-fold increased probability of late discharge, and the results were consistent for the subgroups. Next, a non-linear (S-shaped) relationship between LnNT-proBNP7 and late discharge was observed, whose turning points were 7.5 and 9. The effect sizes and the confidence intervals on the left of the first turning point, between two turning points and on the right of the second turning point, were 0.6 (95% CI, 0.2–1.6), 5.0 (95% CI, 2.4–10.6), and 1.1 (95% CI, 0.2–6.1), respectively. In addition, the prevalence of BPD, NEC, nosocomial infection, or any of them was highest in the group of LnNT-proBNP7 ≥ 9, lowest in the group of LnNT-proBNP7 < 7.5.ConclusionHigher NT-proBNP7 levels were associated with longer hospitalization. The relationship between LnNT-proBNP7 and late discharge was S-shaped. LnNT-proBNP7 was positively related with late discharge when LnNT-proBNP7 was between 7.5 and 9.

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Section: Introductionmentioning

confidence: 99%

Association Between NT-proBNP and Prolonged Length of Stay in Hospital Among Preterm Infants Born at 28–31 Weeks' Gestation

Luo

Lei

et al. 2022

Front. Pediatr.

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“…Then, after a full-text review of 160 studies, 128 were excluded. Finally, a total of 32 studies were included in the systematic review, of which 18 studies were included in the meta-analysis ( 17 - 20 , 24 - 37 ) and 14 were not ( 38 - 51 ) ( Figure 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…The characteristics of the 32 included studies were summarized in Table 1 , with 14 published after 2016 ( 17 , 18 , 24 - 28 , 37 - 42 , 51 ) and 18 published before 2016 ( 19 , 20 , 29 - 36 , 43 - 50 ). The studies were published between 2008 and 2021 involving a total of 7,571 participants.…”

Section: Resultsmentioning

confidence: 99%

“…The studies were published between 2008 and 2021 involving a total of 7,571 participants. Twenty-one (65.6%) studies ( 18 - 20 , 24 , 26 - 31 , 33 - 37 , 40 , 41 , 45 - 47 , 49 ) were conducted in the European countries and 11 (34.4%) studies ( 17 , 25 , 32 , 38 , 39 , 42 - 44 , 48 , 50 , 51 ) in non-European countries. All studies sampled CHD patients from clinic-based population.…”

Section: Resultsmentioning

confidence: 99%

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Prognostic value of N-terminal pro-form B-type natriuretic peptide (NT-proBNP) in patients with congenital heart disease undergoing cardiac surgery: a systematic review and meta-analysis of cohort studies

Gong¹,

Xing²,

Wu³

et al. 2022

Cardiovasc Diagn Ther

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Background: To perform an updated and comprehensive meta-analysis on the prognostic value of N-terminal pro-form B-type natriuretic peptide (NT-proBNP) in patients with congenital heart disease (CHD) undergoing cardiac surgery.Methods: A systematic search was conducted until September 2021 for relevant studies published in PubMed, Web of Science Database and Embase. Based on the average values, NT-proBNP concentrations were classified as high and low levels. The outcomes of interest were mortality, cardiovascular events, and other postoperative outcomes. A random-effects model was used to calculate composite risk estimates and corresponding 95% confidence intervals (CIs). Possible sources of heterogeneity and stability of results were analyzed using subgroup and sensitivity analyses.Results: A total of 32 studies published between 2008 and 2021 involving 7,571 participants were included.Results showed CHD patients at high NT-proBNP levels yielded an increased risk of mortality [risk ratio (RR) =1.14; 95% CI: 1.08-1.20] and cardiovascular events (RR =2.02; 95% CI: 1.26-3.24) compared with those at low NT-proBNP levels. No significant association was found between NT-proBNP and risks for other postoperative outcomes in CHD patients undergoing cardiac surgery (RR =1.73; 95% CI: 0.86-3.47).Significant heterogeneity was detected across studies regarding these risk estimates. Subgroup analysis found heterogeneity in the risk estimate of mortality was explained by geographic region, type of CHD, and assay method of NT-proBNP. Sensitivity analysis supported the robustness of results.Conclusions: Compared with CHD patients at low NT-proBNP levels, CHD patients at high NT-proBNP levels had elevated risks of mortality and cardiovascular events. Further large-scale and wellcontrolled studies are needed to confirm our findings.

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“…Furthermore, the ROC analysis showed that preoperative RVD could provide reasonable classification of patients with prolonged CPB time and PLOS. It has been proved that prolonged CPB time and PLOS could reflect the adverse outcome in cardiac surgical patients (32)(33)(34). To some extent, microcirculatory impairment might play an important role in the outcome of cardiac surgery.…”

Section: Discussionmentioning

confidence: 99%

Improved Retinal Microcirculation After Cardiac Surgery in Patients With Congenital Heart Disease

Liu

Zhu

Yuan

et al. 2021

Front. Cardiovasc. Med.

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Background: Microcirculatory changes in congenital heart disease (CHD) patients undergoing cardiac surgery are not fully understood. We aimed to investigate the changes of retinal microcirculation in CHD patients after cardiac surgery by optical coherence tomography angiography (OCTA) and explore the association between retinal microcirculation and surgical outcome.Methods: This prospective observational study consisted of 71 CHD patients aged ≥6 years undergoing cardiac surgery including 19 cyanotic CHD (CCHD) and 52 acyanotic CHD (ACHD). Optical coherence tomography angiography (OCTA) was used to measure vessel density (VD) and capillary density (CD) of radial peripapillary capillary (RPC) and peripapillary, VD of superficial capillary plexus (SCP) and deep capillary plexus (DCP), thickness of retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) preoperatively and 1 month postoperatively. Transthoracic echocardiography was conducted to measure macrocirculation.Results: In CCHD patients, VD and CD of RPC and peripapillary increased postoperatively (all P < 0.05). In ACHD patients, VD of peripapillary, CD of RPC and peripapillary, and RNFL thickness increased postoperatively (all P < 0.05). VD of SCP and DCP, and GCC thickness did not change significantly in CHD patients after surgery. Lower preoperative retinal microvascular density was associated with longer cardiopulmonary bypass (CPB) time and postoperative length of stay (PLOS). No correlation was found between microcirculatory and macrohemodynamic parameters (all P > 0.05).Conclusions: Improved retinal microcirculation was observed after congenital cardiac surgery and impaired preoperative retinal microvasculature was associated with prolonged CPB time and PLOS, which might provide potential information about the outcome of congenital cardiac surgery.

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Cardiac Biomarkers Associated With Hospital Length of Stay After Pediatric Congenital Heart Surgery

Cited by 10 publications

References 23 publications

Association Between NT-proBNP and Prolonged Length of Stay in Hospital Among Preterm Infants Born at 28–31 Weeks' Gestation

Association Between NT-proBNP and Prolonged Length of Stay in Hospital Among Preterm Infants Born at 28–31 Weeks' Gestation

Prognostic value of N-terminal pro-form B-type natriuretic peptide (NT-proBNP) in patients with congenital heart disease undergoing cardiac surgery: a systematic review and meta-analysis of cohort studies

Improved Retinal Microcirculation After Cardiac Surgery in Patients With Congenital Heart Disease

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