| Background and Objective: Pulmonary hypertension is a serious disease which hazardto human life and health, According to conservative estimates, there are about12millionpatients with pulmonary hypertension at present. Pulmonary hypertension is divided intoprimary and secondary type. Transcatheter closure is a actively seek effective ways to treatcongenital heart disease. It can slow down or improve the high pulmonary blood flow whichdue to the formation of pulmonary vascular remodeling and pulmonary hypertension. And itis important for the improvement of surgical success and prognosis of patients withcongenital heart disease. BNP is related to heart failure, acute coronary syndrome,hypertension and other diseases closely. and showed a correlation between BNP release andpressure. BNP can be used as an independent risk factor of idiopathic pulmonaryhypertension prognosis. This article aims to discuss the congenital heart disease withpulmonary hypertension treated by medication and by the catheter, and the change of plasmaBNP concentration and prognosis.Methods:This study collected patients with congenital heart disease in department ofcardiology of my hospital from February2010to February2012. We use the dopplerultrasound examination prompted the pulmonary artery systolic pressure≥40mmHg as thepreliminary diagnostic criteria of pulmonary hypertension. Exclude the patient combinedwith other structural heart disease, hypertension, congenital compound deformities,abnormal renal function and heart failure. There are total of20patients included in the study,8males and12females, Atrial septal defect (ASD) in10cases,4cases of ventricular septal(VSD), patent ductus arteriosus closure(PDA)6.Nine patients with congenital heartdisease do the surgery successfully, in ntraoperative measurement of pulmonary arterypressure, and we determine the plasma BNP levels by ELISA before surgery, the next dayafter surgery, one month after surgery respectively. Compare to Changes in BNP of10casesof patients with congenital heart disease with pulmonary hypertension whom are given Drugtreatment. We do the Two-dimensional echocardiography examination before interventionaltherapy and a week after the surgery. Observe the atrioventricular size, left ventricular posterior wall (LVPW), left ventricular fractional shortening (LVFS), Arterial oxygensaturation (SO2),6-minute walk test(6-MWT) and changes in pulmonary artery pressure(PAP).Results: There are9cases of congenital heart disease with pulmonary hypertensionunderwent interventional treatment successfully, no complications, the pulmonary arterypressure drop after transcatheter closure. One week after the interventional treatment theLVEF and LVFS decline.24hours after the determination part of the ventricular septaldefect in patients with BNP levels increased compared with the preoperative. One monthafter determination of plasma BNP levels were significantly decreased. The BNP level of thepatients who did the interventional procedures decreased significantly higher than the peoplewho are treated by the drug, and statistically significant1. Conclusion:1.The patients who have congenital heart disease with pulmonary arterypressure increased plasma BNP levels in varying degrees.2. One month after transcatheter closure, blood BNP levels were significantly lowerthan the preoperative, and reducing pulmonary artery pressure more significantly thantraditional drug treatment.3.The BNP level of some patient with Ventricular septal defect did not decline in24hours after surgery as we expected,but increased instead.I think it may be related to thesurgical procedure that stimulate to the ventricular myocytes or Left ventricular volume loadincreased. |
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