The Level Of The Serum BNP In Children Congenital Heart Disease And The Correlation Between The BNP And Cardiac Function

[Objective] To investigate the level of serum brain natriuretic peptide (BNP) in children with left to right shunt congenital heart disease(CHD), analyze the correlation between the serum BNP and cardiac function, ventricular volume lord, pulmonary artery pressure and heart remodeling. The aim to do this is to make an objective parameter for assessment the cardiac function, help us to understand hemodynamics state of CHD patient more clearly and aid us to choose the optimal treatment opportunity and method in clinical practice.[Method] 1. 78 cases of left to right shunt congenital heart disease(CHD) included ventricular septal defect, atrial septal defect and patent ductus arteriosus in hospital were enrolled from the patients in the Cardiology Dept. of Tianjin Children's hospital and diagnosed by color Doppler ultrasound. 30 cases of control group which had normal blood Rt, ECG and X-ray check and had no deviation in the age and sex were selected from the patients in the prevent surgery. We adopted the ELISA method to measure the content of serum BNP in the patients of the contrast group and the patient group. The patient group was divided into three groups, which were ventricular septal defect group, atrial septal defect group and patent ductus arteriosus group. We divided the patient group into two groups, which were named large shunt group and small shunt group according to the ratio of pulmo and systemic circulation. We classified the patient group into two groups, which were named heart failure group, and non-heart failure group and divided the patient group into two groups, which were named pulmonary artery hypertension group and non-pulmonary artery hypertension group according to the mean pressure ofpulmonary artery. 3.We applied the Philips Sonos 5500 type Echocardiogram to measure the left atrium diameter(LAD), left ventricular end systolic inner diameter(LVESD), left ventricular end diastolic inner diameter(LVEDD ) , end-systolic wall thickness of the left ventricular and the blood velocity of each cardiac valve in the patient group, calculated left atrial diameter index (LADI)> left ventricular end diastolic diameter index (LVEDDI^ LV^ LVEF^ CCK mean pulmonary artery pressure > ratio of pulmo and systemic circulation (Qp/Qs^ left ventricular end diastolic volume index (LVEDVI)> left ventricular end-systolic wall stress(LVESWS) and left ventricular mass index (LVmassI). 4. We analysis all the datum with SPSS 11.5 For Windows.[Result] 1. The serum BNP in patient group is higher than the contrast group (p<0.05);Their's level of the different types of congenital heart disease are significantly higher than the contrast group (p<0.01). The serum BNP is higher in heart failure group than in non-heart failure group (p <0.01), so is that it's higher in large shunt group than in small shunt group (p <0.05) and it's higher in pulmonary artery hypertension group than in non-pulmonary artery hypertension group (p<0.05). 2. The ratio of left atrial enlargement in infant and young children with left to right CHD is more than that of the left ventricular enlargement (p <0.05). The left atrial diameter index, left ventricular diameter index and left ventricular mass index of heart failure group are larger than those of non-heart failure group (p<0.01). The left ventricular end diastolic volume index and left ventricular end-systolic wall stress of heart failure group are larger than those of non-heart failure group (p<0.05). There have no statistical significantly difference of left ventricular shorteningfraction, ejection fraction and cardiac output between the two groups of heart failure group and non-heart failure group (p>0.05). 3. There is one kind of positive rank correlation between the serum level of BNP and heart failure, left atrial diameter index, left ventricular diameter index, left ventricular end diastolic volume index and left ventricular end-systolic wall stress (p<0.05).[Conclusion] 1. The serum BNP in children with left to right shunt congenital heart disease(CHD) is increased significantly . The serum BNP can be done as an objective index in auxiliary diagnosis and the severity appraisal of the left to right shunt CHD. 2. The serum BNP in heart failure group of pediatric left to right shunt CHD is higher than that of non- heart failure group. The serum BNP may be done as an objective parameter in assessment of the cardiac function in CHD. 3. The serum BNP is higher in pulmonary artery hypertension group than in non-pulmonary artery hypertension group. So the serum BNP can be done as a no-trauma index to monitor hemodynamics state of CHD patient more clearly and to provide a theorical direction for choice the optimal treatment opportunity and method in clinical practice. 4. There is a positive rank correlation between the serum BNP and the left atrial diameter index, left ventricular end diastolic diameter index, left ventricular end diastolic volume index and left ventricular end systolic wall stress. The serum BNP can reflect the degree of the volume load and pressure lord in CHD and direct the treatment of cardiac failure.