Elevated Plasma B-type Natriuretic Peptide and C-reactive Protein Levels in Children with Restrictive Right Ventricular Physiology Following Tetralogy of Fallot Repair

Xu, Zhiwei; Zhang, Mingjie; Zhu, Limin; Gong, Xiaolei; Li, Jia

doi:10.1111/chd.12166

Cited by 9 publications

(7 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[157][158][159]163,165 BNP in tetralogy of Fallot The clinical relevance of BNP in the integrated followup of patients after tetralogy of Fallot repair has been assessed in several studies. [167][168][169][170][171][172][173][174][175][176][177][178][179][180][181][182][183][184][185][186] Patients after tetralogy of Fallot correction can demonstrate a series of typical pathological sequelae, such as residual pulmonary regurgitation and/or stenosis, causing right ventricular dilatation, hypertrophy, or both. Patients with these cardiac alterations may be initially asymptomatic, but subsequently deteriorate progressively into having symptomatic heart failure.…”

Section: Bnp In the Follow-up Of Corrected/palliated Chdmentioning

confidence: 99%

“…167,168 At present, there are no solid guidelines for the management of these patients, in particular concerning the critical values of elevated right ventricular dimensions to take into account for an eventual re-intervention. [167][168][169][170][171][172][173][174][175][176][177][178][179][180][181][182][183][184][185][186] The use of BNP may provide important additional information both for the evaluation of asymptomatic individuals as well to grade and monitor the degree of heart failure. [8][9][10] In the last decade, a large number of studies have reported significant relationships between circulating levels of biomarkers and several structural and functional parameters as assessed by echocardiography and MRI.…”

Section: Bnp In the Follow-up Of Corrected/palliated Chdmentioning

confidence: 99%

“…[8][9][10] In the last decade, a large number of studies have reported significant relationships between circulating levels of biomarkers and several structural and functional parameters as assessed by echocardiography and MRI. [167][168][169][170][171][172][173][174][175][176][177][178][179][180][181][182][183][184][185] The majority of these studies have demonstrated a significant association between BNP levels and the degree of pulmonary regurgitation, right ventricular end-diastolic volume, and systolic pressure. [171][172][173][177][178][179]181 On the other hand, conflicting results were reported concerning the association between BNP levels with right ventricular function.…”

Section: Bnp In the Follow-up Of Corrected/palliated Chdmentioning

confidence: 99%

See 2 more Smart Citations

BNP in children with congenital cardiac disease: is there now sufficient evidence for its routine use?

et al. 2015

View full text Add to dashboard Cite

Interest in brain natriuretic peptide (BNP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) in the management of children with CHD has increased. There are, however, no current guidelines for their routine use. The aim of this review article is to provide an update on the data regarding the use of BNP/NT-proBNP in the evaluation and surgical treatment of children with CHD. BNP/NT-proBNP levels in children with CHD vary substantially according to age, laboratory assay methods, and the specific haemodynamics associated with the individual congenital heart lesion. The accuracy of BNP/NT-proBNP as supplemental markers in the integrated screening, diagnosis, management, and follow-up of CHD has been established. In particular, the use of BNP/NT-proBNP as a prognostic indicator in paediatric cardiac surgery has been widely demonstrated, as well as its role in the subsequent follow-up of surgical patients. Most of the data, however, are derived from single-centre retrospective studies using multivariable analysis; prospective, randomised clinical trials designed to evaluate the clinical utility and cost-effectiveness of routine BNP/NT-proBNP use in CHD are lacking. The results of well-designed, prospective clinical trials should assist in formulating guidelines and expert consensus recommendations for its use in patients with CHD. Finally, the use of new point-of-care testing methods that use less invasive sampling techniques -capillary blood specimens -may contribute to a more widespread use of the BNP assay, especially in neonates and infants, as well as contribute to the development of screening programmes for CHD using this biomarker.

show abstract

Section: Bnp In the Follow-up Of Corrected/palliated Chdmentioning

confidence: 99%

Section: Bnp In the Follow-up Of Corrected/palliated Chdmentioning

confidence: 99%

Section: Bnp In the Follow-up Of Corrected/palliated Chdmentioning

confidence: 99%

See 1 more Smart Citation

BNP in children with congenital cardiac disease: is there now sufficient evidence for its routine use?

et al. 2015

View full text Add to dashboard Cite

show abstract

“…In the case of Child A it may be that early extubation was in her best interests. A late complete tetralogy of Fallot repair in an older child may result in the occurrence of restrictive right ventricular physiology during the initial post-operative period more frequently than if the repair is completed electively during infancy due to ventricular hypertrophy and fibrosis (32). If clinically significant, left ventricular filling may also be indirectly affected (33).…”

Section: Discussionmentioning

confidence: 99%

A Case Report Examining Early Extubation Following Congenital Heart Surgery in a Low Resource Setting

Howes

2019

Front. Pediatr.

View full text Add to dashboard Cite

This case report aims to critically analyse the evidence surrounding early extubation in the post-operative phase following complex congenital cardiac surgery. Child A was an 8 year old female who had undergone complex congenital cardiac surgery during an international surgical charity mission. On admission to the paediatric intensive care unit Child A appeared to be in good condition and no major complications had occurred intra-operatively. This was considered alongside the situational pressures of resource limitations and the mission's aim to offer surgery to as many children as possible during the available time frame. The decision was made by the team that Child A was a suitable candidate for ‘early extubation.’ Some members of the team were uncomfortable with this approach and felt it could lead to poorer outcomes for patients. Current evidence surrounding early extubation both within international surgical mission trips to low-income and middle-income countries and established cardiac centres within high-income countries is examined and discussed alongside the context of resource limitation. Although the process and implications of early extubation following cardiac surgery needs further research, on the basis of the evidence currently available clinicians could potentially encourage the use of early extubation within clinical practice (for appropriately selected patients) through the utilisation of a multidisciplinary approach, both within the UK and during international surgical charity missions to low-income and middle-income countries.

show abstract

“…Further, oxygen transport between patients with restrictive right ventricle and those without right ventricle decides CHD in children [13] Serum kinetics in children is also used to identify atrial and ventricular septal defects closure in terms of extracorporeal circulation. C-reactive protein demonstrates functional status of cardiac muscle functional status.…”

Section: Physiological Markersmentioning

confidence: 99%

Emerging Biomarkers of Congenital Heart Diseases and Disorders

Upadhyay

2016

JSRT

View full text Add to dashboard Cite

Present review aims to discuss new emerging biomarkers that could facilitate authentic and fast diagnosis of congenital heart diseases. The population of congenital heart disease patients is increasing regularly and serious complications in adults are also enormously exceeding in comparison to children. Most of these congenital defects are un-curable and becoming challenging to treat. However, for predicting the prognosis of patient's different types of biomarkers i.e. hemodynamic, physiological, genetic, molecular, immunological, clinical and therapeutic biomarkers are explained. For sequential assessment of major structural and functional defects in CHD (congenital heart diseases) patients various bioassays and scientific methods are used to integrate defects with symptoms to find therapeutic decisions, targets and goals. This article tries to explore therapeutic options and solutions of CHD on the basis of emerging biomarkers and assess the need to advent new potential authentic biomarkers.

show abstract

Elevated Plasma B-type Natriuretic Peptide and C-reactive Protein Levels in Children with Restrictive Right Ventricular Physiology Following Tetralogy of Fallot Repair

Abstract: rRV physiology is associated with significantly higher BNP and CRP levels with poorer balance of systemic oxygen transport. Information about these pathophysiological changes may help to identify appropriate treatment strategies in this difficult group of patients.

Cited by 9 publications

References 26 publications

BNP in children with congenital cardiac disease: is there now sufficient evidence for its routine use?

BNP in children with congenital cardiac disease: is there now sufficient evidence for its routine use?

A Case Report Examining Early Extubation Following Congenital Heart Surgery in a Low Resource Setting

Emerging Biomarkers of Congenital Heart Diseases and Disorders

Contact Info

Product

Resources

About