Plasma Natriuretic Peptides As Predictors of Hemodynamically in Children with Congenital Heart Disease

Background: The objects of the study was to investigate the role and importance of N-Terminal Pro-B-Type natriuretic peptide (NT-Pro-BNP) as a biochemical marker in patients with congenital heart disease and to determine if there is any relationship between anthropometric measurements and natriuretic peptide. Method: Forty-five children with CHD (17 cyanotic and 28 acyanotic) and thirty children with normal echocardiography were enrolled in the study. Patients were divided into two groups as cyanotic or acyanotic. Anthropometric measurements including body weight, height, BMI and Zscore(weight) and Z-score(height) and thorough physical examination were recorded on admission. Serum NT-Pro-BNP was also measured Results: Majority of patients in cyanotic and acyanotic groups had tetralogy of fallot and ventricular septal defect, respectively. The mean age was significantly lower in cyanotic patients compared with acyanotic and controls. N-Terminal-Pro-B-Type natriuretic peptide levels were significantly elevated in cyanotic and acyanotic patients compared with controls. N-Terminal-ProBNP was negatively correlated with left ventricular ejection fraction among the echocardiographic parameters (p=0.014, r=-0.364). In acyanotic patients, NT-Pro-BNP was positively correlated with shunt ratio (p=0.029, r=0,428) and Systolic pulmonary arterial pressure (p=0.005, r= 0.519) while it was negatively correlated with Z-score (weight) (p=0.044, r=-0.390). Conclusion N-Terminal-pro-BNP is one of essential serum markers for cardiac disease and it could be used to predict the severity and prognosis of CHD as a response to ventricular volume expansion and pressure overload