ABSTRACT
OBJECTIVE: We measured serum NT-proBNP levels in 2 groups of young patients (0-36 months) with congestive heart failure (CHF) secondary to congenital heart malformations (CHM). METHODS: The first group included 23 patients prior to surgery for heart malformations. The second group included 12 patients with CHM within 24 hours post-operation. NT-proBNP levels were measured by an enzyme-linked immunosorbent immunoassay (ELISA) using the Chem Well 2910 (Awareness Technology Inc.) automated analyzer. RESULTS: NT-proBNP values were 4 times higher in patients with unoperated CHM compared to healthy controls (P < 0.001), and 12 times higher in patients with CHM 24 hours after surgery compared to controls (P = 0.0001). CONCLUSIONS: These results demonstrated significant changes in NT-proBNP concentrations before and after surgery to correct congenital heart malformations.
Subject(s)
Heart Defects, Congenital/blood , Heart Failure/blood , Natriuretic Peptide, Brain/blood , Peptide Fragments/blood , Age Factors , Biomarkers/blood , Case-Control Studies , Child, Preschool , Female , Heart Defects, Congenital/complications , Heart Defects, Congenital/surgery , Heart Failure/etiology , Heart Failure/surgery , Humans , Infant , MaleABSTRACT
The diagnosis of cardiovascular malformations (CVM) is based on the echocardiographic evaluation. Multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) are performant, necessary techniques for the pre- and postoperative assessment of complex malformations, especially of cyanogenic malformations, in which anomalies of the right side of the heart and of the pulmonary circulation are involved and where echocardiography has a limited role. The complementarity of echocardiography with MDCT and MRI for the acquisition of the details necessary for an accurate therapeutic decision and for avoiding invasive exploration, as well as the close relationship between the radiologist and the clinician are crucial and all the more necessary in complex malformations.
Subject(s)
Echocardiography/methods , Heart Defects, Congenital/diagnosis , Image Enhancement/methods , Magnetic Resonance Imaging/methods , Subtraction Technique , Tomography, X-Ray Computed/methods , HumansABSTRACT
Echocardiography is the first technique used for diagnosing cardiovascular malformations (CVM). The results are often completed with multi-detector computer tomography (MDCT) and/or magnetic resonance imaging (MRI) for confirming/ invalidating an abnormal pulmonary venous return in the case of atrial septal defect (ASD) or for the exact interpretation of cardiac function in pre/post-surgery cases with ASD, ventricular septal defect (VSD), and Fallot tetralogy. MDCT and MRI play an important role in the precise and complete diagnosis of Fallot tetralogy, in the anomalies of the right heart cavities and the arterial and venous pulmonary tree, the anomalies of the emergence and course of the coronary arteries, aortic coarctation and developmental anomalies of the aortic arch and supraaortic trunks. The complementarity of echocardiography with MDCT and MRI, in order to obtain details and to avoid invasive procedures and also the cooperation between the pediatrician, cardiologist, surgeon and radiologist, represent the key to the diagnosis and treatment of cardiovascular malformations, for the benefit of the patient.
