Relationship Between Serum Brain-Type Natriuretic Peptide and Biomarkers of Growth in Infants With Shunt-Dependent Single Cardiac Ventricle

Gardner, Monique M.; Faerber, Jennifer; Glatz, Andrew C.; Preminger, Tamar J.; Avitabile, Catherine M.; Shankar, Somya; Shustak, Rachel J.; Weber, David R.; Schachtner, Susan; Ravishankar, Chitra; Goldberg, David J.

doi:10.1016/j.amjcard.2022.01.052

Cited by 3 publications

(3 citation statements)

References 22 publications

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“…Serum brain natriuretic peptide (BNP) is a well known marker for congestive heart failure. A prospective observational pilot study ( n = 38) explored the relationship between heart failure as assessed by BNP and growth factors such as insulin like growth factor I and insulin like growth factor binding protein 3 [24 ▪ ]. These measurements were made before discharge from the neonatal hospitalization, immediately before and after discharge from the SCPC.…”

Section: Energy Expenditurementioning

confidence: 99%

Feeding challenges in the newborn with congenital heart disease

Ravishankar

2022

Current Opinion in Pediatrics

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Purpose of reviewFeeding challenges and growth failure are lifelong issues for infants with congenital heart disease. The purpose of this review is to summarize the literature on the topic from North America.Recent findingsDespite recognition of feeding challenges and ongoing national collaboration, >50% of infants with univentricular physiology continue to require supplemental tube feeds at the time of discharge from neonatal surgery. Preoperative feeding is now commonly used in prostaglandin dependent neonates with congenital heart disease. The value of a structured nutritional program with establishment of best practices in nutrition is well recognized in the current era. Despite implementation of these best practices, neonates undergoing cardiac surgery continue to struggle with weight gain prior to discharge. This suggests that there is more to growth than provision of adequate nutrition alone.SummaryThe National Pediatric Cardiology Quality Improvement Collaborative continues to play a major role in optimizing nutrition in infants with congenital heart disease. This among other registries underscores the importance of collaboration in improving overall outcomes for children with congenital heart disease. Nurses should be encouraged to lead both clinical and research efforts to overcome feeding challenges encountered by these children.

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Section: Energy Expenditurementioning

confidence: 99%

Feeding challenges in the newborn with congenital heart disease

Ravishankar

2022

Current Opinion in Pediatrics

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“…Burch et al hypothesizes that this may be explained by the higher energy expenditure associated with BTT shunt physiology (10,33,34). Furthermore, a recent pilot study in shunt-dependent infants demonstrated an inverse relationship between brain natriuretic peptide (BNP) and insulin like growth factor 1, a correlate of weight gain in infancy (35,36). Given variability in right ventricle volume loading by shunt type and size, the relationship of shunt type, BNP, and weight gain merits further investigation.…”

Section: Discussionmentioning

confidence: 99%

Neighborhood Social Vulnerability and Interstage Weight Gain: Evaluating the Role of a Home Monitoring Program

Shustak¹,

Huang

Tam

et al. 2023

Preprint

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Introduction: Poor interstage (IS) weight gain is a risk factor for adverse outcomes in infants with hypoplastic left heart syndrome (HLHS). We sought to examine the association of neighborhood social vulnerability and IS weight gain and determine if this association is modified by enrollment in our institution's Infant Single Ventricle Management and Monitoring Program (ISVMP). Methods: We performed a retrospective single-center study of infants with HLHS before (2007-2010) and after (2011-2020) the introduction of the ISVMP. The primary outcome was IS weight gain, and the secondary outcome was IS growth failure. Multivariable linear and logistic regression models were used to examine the association between Social Vulnerability Index (SVI) and the outcomes. We introduced an interaction term into the models to test for effect modification by ISVMP. Results: We evaluated 217 ISVMP infants and 111 pre-ISVMP historical controls. SVI was associated with IS growth failure (P = 0.001), however, enrollment in ISVMP strongly attenuated this association (P = 0.04). Pre-ISVMP, high and middle vulnerability infants gained 4 gm/day less and were significantly more likely to experience growth failure than low vulnerability infants (high vs. low: aOR 12.5; 95% CI 2.5-62.2; middle vs. low: aOR 7.8; 95% CI 2.0-31.2). After the introduction of the ISVMP, outcomes did not differ by SVI tertile. Middle and high SVI infants enrolled in ISVMP gained 4 gm/day and 2 gm/day more, respectively, than pre-ISVMP controls. Conclusion: In infants with HLHS, high social vulnerability is a risk factor for poor IS weight gain. However, enrollment in ISVMP significantly reduces growth disparities.

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“… 11 , 39 , 40 Furthermore, a recent pilot study in shunt‐dependent infants demonstrated an inverse relationship between brain natriuretic peptide and insulin like growth factor 1, a correlate of weight gain in infancy. 41 , 42 Given variability in right ventricle volume loading by shunt type and size, the relationship of shunt type, brain natriuretic peptide, and weight gain merits further investigation.…”

Section: Discussionmentioning

confidence: 99%

Neighborhood Social Vulnerability and Interstage Weight Gain: Evaluating the Role of a Home Monitoring Program

Shustak,

Huang,

Tam

et al. 2023

JAHA

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Background Poor interstage weight gain is a risk factor for adverse outcomes in infants with hypoplastic left heart syndrome. We sought to examine the association of neighborhood social vulnerability and interstage weight gain and determine if this association is modified by enrollment in our institution's Infant Single Ventricle Management and Monitoring Program (ISVMP). Methods and Results We performed a retrospective single‐center study of infants with hypoplastic left heart syndrome before (2007–2010) and after (2011–2020) introduction of the ISVMP. The primary outcome was interstage weight gain, and the secondary outcome was interstage growth failure. Multivariable linear and logistic regression models were used to examine the association between the Social Vulnerability Index and the outcomes. We introduced an interaction term into the models to test for effect modification by the ISVMP. We evaluated 217 ISVMP infants and 111 pre‐ISVMP historical controls. The Social Vulnerability Index was associated with interstage growth failure ( P =0.001); however, enrollment in the ISVMP strongly attenuated this association ( P =0.04). Pre‐ISVMP, as well as high‐ and middle‐vulnerability infants gained 4 g/d less and were significantly more likely to experience growth failure than low‐vulnerability infants (high versus low: adjusted odds ratio [aOR], 12.5 [95% CI, 2.5–62.2]; middle versus low: aOR, 7.8 [95% CI, 2.0–31.2]). After the introduction of the ISVMP, outcomes did not differ by Social Vulnerability Index tertile. Infants with middle and high Social Vulnerability Index scores who were enrolled in the ISVMP gained 4 g/d and 2 g/d more, respectively, than pre‐ISVMP controls. Conclusions In infants with hypoplastic left heart syndrome, high social vulnerability is a risk factor for poor interstage weight gain. However, enrollment in the ISVMP significantly reduces growth disparities.

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Relationship Between Serum Brain-Type Natriuretic Peptide and Biomarkers of Growth in Infants With Shunt-Dependent Single Cardiac Ventricle

Cited by 3 publications

References 22 publications

Feeding challenges in the newborn with congenital heart disease

Feeding challenges in the newborn with congenital heart disease

Neighborhood Social Vulnerability and Interstage Weight Gain: Evaluating the Role of a Home Monitoring Program

Neighborhood Social Vulnerability and Interstage Weight Gain: Evaluating the Role of a Home Monitoring Program

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