Value of plasma brain natriuretic peptide levels on the cardiac function evaluation in children with left-right shunt congenital heart disease / 中国医师进修杂志

ABSTRACT

Objective To study the value of plasma brain natriuretic peptide (BNP) levels on the cardiac function evaluation in children with left-right shunt congenital heart disease (CHD).Methods Thirtytwo children with left-right shunt CHD were selected and divided into right ventricular group (14 cases) and left ventricular group (18 cases) according to the heart load capacity types.Twenty healthy children were selected as control group.Then plasma BNP levels were determined by enzyme-linked immunosorbent assay method and the left ventricular ejection fraction (LVEF),left ventricular end-diastolic diameter (LVEDD),right ventricular end-diastolic diameter (RVEDD),pulmonary blood flow (Qp)/systemic blood flow ratio(Qs) and left heart Tei index were determined by echocardiography and compared.Results The plasma BNP levels,LVEDD,RVEDD,Qp/Qs and left heart Tei index were (60.21 ± 26.78) rng/L,(35.71 ± 6.98) mm,(25.04 ± 5.52) mm,1.74 ± 0.24,0.34 ± 0.12 in right ventricular group.The plasma BNP levels,LVEDD,RVEDD,Qp/Qs and left heart Tei index were (64.57 ± 25.18) ng/L,(45.27 ± 7.26) mm,(12.34 ± 2.18) mm,1.78 ± 0.19,0.36 ± 0.11 in left ventricular group.The plasma BNP levels,LVEDD,RVEDD,Qp/Qs and left heart Tei index were (33.42 ± 9.46) ng/L,(32.31 ± 4.87) mm,(10.98 ± 1.60) mm,0.92 ± 0.11,0.28 ± 0.08 in control group.The plasma BNP levels,LVEDD,RVEDD,Qp/Qs and left heart Tei index in right ventricular group and left ventricular group were higher than those in control group,and there were significant differences (P ＜ 0.05).There was no significant difference in LVEF among three groups (P ＞ 0.05).The plasma BNP levels in right ventricular group had positive correlation with RVEDD (r =0.634,P ＜ 0.05),Qp/Qs (r =0.721,P ＜ 0.05) and left heart Tei index (r =0.647,P ＜ 0.05).The plasma BNP levels in left ventricular group had postive correlation with LVEDD (r =0.547,P ＜ 0.05),Qp/Qs(r =0.794,P ＜ 0.05) and left heart Tei index (r =0.745,P ＜ 0.05).There was no correlation between the plasma BNP levels and LVEF in right ventricular group and left ventricular group.Conclusion The plasma BNP levels determination helps the early cardiac function evaluation of left-right shunt CHD,and combined with echocardiography can accurately reflect the early cardiac function of the left-right shunt CHD,which can provide objective basis for the clinical diagnosis and treatment.