Clinical Significance Of Changes Of Plasma N-terminal Pro-brain Natriuretic Peptide In Children With Congenital Heart Disease Combined With Heart Failure

Objective:To observe the changes of plasma N－terminal pro－brainnatriuretic peptide (NT－proBNP) in children with congenital heartdisease(CHD) combined with heart failure(HF)，and analyze the relationshipbetween the severity of HF and NT－proBNP levels，and explore its clinicalsignificance in the diagnosis of HF and cardiac functionclassification． Methods: Forty－six patients with CHD and HF in theAffiliated Hospital of Guilin Medical University were collected randomly fromJun．2008to Jun．2011，and they were divided into3groups according to theevaluation criteria of New York University Pediatric Heart Failure Index (NYUPHFI):non－HF group (15patients)， mild HF group(16patients) and moderateto severe HF group (15patients)．Twenty－five healthy children were selectedas the healthy control group． Blood samples of all groups werecollected． Concentration of plasma NT－proBNP was determined by enzyme－linked immunosorbent assay． The left ventricular ejection fraction (LVEF)and the ratio of early－diastolic peak flow velocity and late－diastolic peak flow velocity (E/A)were determined． The relationships between plasma NT－proBNP levels and modified Ross score and echocardiographic cardiacfunctional indexes were analyzed． Results: Plasma NT－proBNP waspositively correlated with the severity of HF (r=0.82， P＜0.01)， the moreserious the HF was，the higher the plasma NT－proBNP concentration． PlasmaNT－proBNP level in moderate to severe HF group was significantly higherthan that in mild HF group (P＜0.01)，plasma NT－proBNP level in mild HFgroup was higher than that in non－HF group (P＜0.01)，and plasma NT－proBNP level in non－HF group was significantly higher than that in healthycontrol group (P＜0.01)．Plasma NT－proBNP level was negatively correlatedwith LVEF (r=－1.20，P＜0.01)． Conclusions: Plasma NT－proBNPconcentration will elevate with the increase of the serious degree of HF，whichindicates that the test of plasma NT－proBNP will be of significant clinicalsignificance in assessing the disease severity and prognosis of the CHD childrencombined with HF．...