ABSTRACT
Objective To observe the changes of tissue doppler Tei index (TDI-Tei index) and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in children with atrial septal defect(ASD) before and after interventional therapy,in order to investigate the evaluation value of the two parameters on the improvements of right cardiac function.Methods Ninety children with ASD who were treated in the First Hospital of Hebei Medical University from June 2013 to June 2015 as the ASD group,including 48 male and 42 female at the age of (3.0-13.0) years old,and the average age was (5.4±2.7) years old.Fifty healthy children with matched age and gender as the control group.Concentrations of serum NT-proBNP were measured by using Bi-directional lateral flow immunoassay before and the 7th day and 6th month after cardiac catheterization,respectively.The right ventricular Tei index(RV-Tei index) was measured by tissue doppler Imaging.The changes and the correlations of parameters before and after interventional therapy were compared and analyzed respectively.Results (1) Before interventional therapy,the right ventricular TDI-Tei index in ASD group was higher than control group(0.56±0.09 vs 0.31 ±0.05,P＜0.01),and the TDI-Tei index was decreased gradually at different time points after interventional therapy in ASD group,especially at the 6th month was lowest(P＜0.01);TDI-Tei indexes at before and the 7th day and 6th month after the procedure were significantly different(0.56±0.09 vs 0.44±0.06,0.56±0.09 vs 0.33±0.04;t=22.56,23.27;P＜0.05).Compared with control group,there was significant difference about the TDI-Tei index in ASD group at the 7th day after transcatheter closure(P＜0.05),while there was no significant difference about TDI-Tei index at the 6th month (P＞0.05).(2) Before interventional therapy,the level of serum NT-proBNP in ASD group was higher than control group ((259.49± 43.99) ng/L vs (102.11 ± 34.53) ng/L,P＜0.01),and the levels of NT-proBNP were decreased gradually at different time points after interventional therapy in ASD group,especially at the 6th month was lowest(P＜0.01);the levels of NT-proBNP at before and the 7th day and 6th month after interventional therapy were significantly different ((259.49 ± 43.99) ng/L vs (192.93 ± 56.46) ng/L,(259.49±43.99) ng/L vs (108.46±36.88) ng/L;P＜0.05).Compared with control group,there was significant difference about the level of serum NT-proBNP in ASD group at the 7th day after transcatheter closure (P ＜0.05),while there was no significant difference about NT-proBNP at the 6th month(P＞0.05).(3) Before and the 7th day and 6th month after interventional therapy,NT-proBNP level and the right ventricular TDI-Tei index was significantly positive correlated in ASD group (r =0.719,0.753,0.732;P＜0.01).Conclusion The changes and correlations of the right ventricular TDI-Tei index and serum NT-proBNP in the children with ASD after intervention operation indicates that TDI-Tei index and serum NT-proBNP could evaluate the improvement of right cardiac function.