Paradoxical Relationship Between B-type Natriuretic Peptide and Pulmonary Vascular Resistance in Patients with Ventricular Septal Defect and Concomitant Severe Pulmonary Hypertension

Toyono, Manatomo; Harada, Kenji; Tamura, Masazumi; Aoki-Okazaki, Mieko; Shimada, Shunsuke; Oyamada, Jun; Takada, Goro

doi:10.1007/s00246-007-9037-7

Cited by 16 publications

(16 citation statements)

References 27 publications

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“…16 Ventricular septal defect A total of 11 articles concerning patients with ventricular septal defect were included, describing a total of 328 patients with unrepaired ventricular septal defect and 43 with repaired ventricular septal defect. 5,11,17,[21][22][23][24][25][26][27][28] All studies comprised children with mean/median age ranging from 4 months to 13.3 years, whereas no studies in adult patients were found. None of the studies reported separate results for muscular or (peri)membranous ventricular septal defect.…”

Section: Atrial Septal Defectmentioning

confidence: 99%

“…Correlations between age and brain natriuretic peptide levels differed widely from non-significant to highly significant negative correlations. 21,24,27 Patients with clinical signs of cardiac failure revealed higher brain natriuretic peptide values than those without clinical signs. 26,28 In all, eight articles described correlations between brain natriuretic peptide and cardiac function parameters (Table 2).…”

Section: Atrial Septal Defectmentioning

confidence: 99%

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The usefulness of brain natriuretic peptide in simple congenital heart disease – a systematic review

Eindhoven¹,

Bosch

Boersma

et al. 2012

Cardiol Young

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Brain natriuretic peptide and N-terminal pro-brain natriuretic peptide are two well-established markers for cardiac failure in acquired heart disease. Nevertheless, the clinical utility of these markers in patients with congenital heart disease remains unclear. Therefore, the aim of this study was to evaluate the diagnostic and prognostic value of these markers in patients with congenital heart disease. A PubMed and EMBASE literature search was executed with focus on the most common simple congenital heart defects, atrial septal defect and ventricular septal defect. Data on brain natriuretic peptide measurement, cardiac function parameters, and follow-up were collected. In patients with atrial or ventricular septal defect, brain natriuretic peptide levels were mildly increased when compared with healthy age-matched controls. Shunt severity and pulmonary artery pressure correlated strongly with natriuretic peptide levels. A clear association between brain natriuretic peptide and functional class was demonstrated. After closure of the defect, a rise in brain natriuretic peptide levels in the first hours to days was observed. After longer follow-up, natriuretic peptide levels decreased and became comparable to pre-procedural values. In conclusion, this systematic review shows that brain natriuretic peptide levels are mildly increased in patients with unrepaired and repaired atrial or ventricular septal defect. Brain natriuretic peptide measurement might be a useful additional tool in the diagnostic work-up of patients with atrial or ventricular septal defect. Further investigation in a larger, prospective study with long-term follow-up is warranted to elucidate the true prognostic value of natriuretic peptides in patients with simple congenital heart disease.

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Section: Atrial Septal Defectmentioning

confidence: 99%

Section: Atrial Septal Defectmentioning

confidence: 99%

The usefulness of brain natriuretic peptide in simple congenital heart disease – a systematic review

Eindhoven¹,

Bosch

Boersma

et al. 2012

Cardiol Young

View full text Add to dashboard Cite

show abstract

“…Plasma BNP is also increased significantly in patients with left-to-right shunts, aortic valve stenosis, coarctation of aorta and patients with functionally univentricular heart in comparison with healthy subjects [31]. In patients with left-to-right shunt lesions, plasma BNP positively correlate to shunt volume, systolic RV pressure, mean pulmonary artery pressure and increasing pulmonary vascular resistance [31,32]. Plasma BNP 20 pg/ml and ANP of 50 pg/ml can identify children with mean pulmonary artery pressure of 20 mmHg with a sensitivity of 82% and 97%, respectively, and a specificity of 89% and 84%, respectively [32].…”

Section: Congenital Heart Diseasementioning

confidence: 99%

“…In patients with left-to-right shunt lesions, plasma BNP positively correlate to shunt volume, systolic RV pressure, mean pulmonary artery pressure and increasing pulmonary vascular resistance [31,32]. Plasma BNP 20 pg/ml and ANP of 50 pg/ml can identify children with mean pulmonary artery pressure of 20 mmHg with a sensitivity of 82% and 97%, respectively, and a specificity of 89% and 84%, respectively [32]. No significant elevation of BNP is found in patients with pulmonary valve stenosis, tetralogy of Fallot, in patients missing a pulmonary ventricle with isolated cavopulmonary failure [31].…”

Section: Congenital Heart Diseasementioning

confidence: 99%

Natriuretic Peptides in Cardiovascular Diseases of Fetus, Infants and Children

Das¹,

Raj²,

Solinger³

2009

CHAMC

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The natriuretic peptides (NP) appear to be functional by midgestation, respond to volume stimuli, and regulate blood pressure and salt and water balance in the developing embryo. In addition, the NP may help regulate the blood supply to the fetus, acting as vasodilators in the placental vasculature. Peaks of ANP and BNP expression during gestation coincide with significant events in cardiac organogenesis, suggesting a role for NP in the formation of the heart. Levels of atrial natriuretic peptide (ANP) are higher in the fetal circulation than in adults, and fetal ventricles express higher levels of ANP and B-type natriuretic peptide (BNP) than adult ventricles. In this comprehensive review we have discussed the role NP during development of the fetal heart and circulation and in various cardiovascular diseases of neonatal and pediatric age group.

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“…However, the relationship between NT-proBNP and catheterization findings was not studied. The only study in children was performed by Toyono et al (19); they investigated the role of NT-proBNP in 29 patients with VSD and severe PHT. Only four patients showed apparent Eisenmenger physiology.…”

Section: Discussionmentioning

confidence: 99%

What Levels of Uric Acid and NT-Probnp Predict Outcomes of Eisenmenger Syndrome in Children?

Pamukçu¹,

Yılmaz²,

Narın³

et al. 2016

Erciyes Med J

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Objective: Noninvasive methods for follow-up of pulmonary hypertensive children are limited. The main aim of this study was to determine the cutoff levels for uric acid and N-terminal pro-brain natriuretic peptide (NT-proBNP) for follow-up of Eisenmenger patients and their relationships with classical methods. To our best knowledge, this is the first study to investigate the levels of NT-proBNP and uric acid in pediatric Eisenmenger patients. Materials and Methods:Sixteen patients with Eisenmenger syndrome and 37 healthy children as controls were included in the study. The serum NT-proBNP and uric acid levels of the participants were measured. The echocardiography, six-minute walk test, and right cardiac catheterization data of the two groups were compared.Results: NT-proBNP>81.4 pg/mL and uric acid >3.5 mg/dL were found to be the most specific and sensitive points for predicting the severity of pulmonary hypertension in Eisenmenger syndrome. There was no significant difference between mean pulmonary arterial pressure and serum NT-proBNP level; however, the differences between pulmonary vascular resistance and serum NT-proBNP level and between mean pulmonary arterial pressure and serum NT-proBNP level were significant. There was no significant difference between NT-proBNP level and New York Heart Association functional classification or six-minute walk test distance. There was no significant difference between serum uric acid level and pulmonary vascular resistance, right atrial pressure, or mean pulmonary arterial pressure. Conclusion:It is too early to determine if serum biomarkers can replace classical diagnostic methods in Eisenmenger syndrome; further studies are required.

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Paradoxical Relationship Between B-type Natriuretic Peptide and Pulmonary Vascular Resistance in Patients with Ventricular Septal Defect and Concomitant Severe Pulmonary Hypertension

Cited by 16 publications

References 27 publications

The usefulness of brain natriuretic peptide in simple congenital heart disease – a systematic review

The usefulness of brain natriuretic peptide in simple congenital heart disease – a systematic review

Natriuretic Peptides in Cardiovascular Diseases of Fetus, Infants and Children

What Levels of Uric Acid and NT-Probnp Predict Outcomes of Eisenmenger Syndrome in Children?

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