Clinical Significance And Changes In Copeptin, Brain Natriuretic Peptide And C-Reactive Protein Concentration On Peripheral Blood In Children With Congenital Heart Disease Combined With Heart Failure

Objective:To explore the clinical significance and changes in copeptin, BNP and CRP concentration on peripheral blood in children with CHD and HEMethods:66children with CHD were divided into HF group, HF with pneumonia group and non-HF group. Pneumonia control group and normal control group were also set up for comparison. The concentration of copeptin, BNP and CRP on peripheral blood and LVEF were detected by ELISA and UCG, respectively.Results:The concentration of copeptin, BNP and CRP on peripheral blood of HF with pneumonia group is greatly higher than that of HF group, non-HF group, pneumonia control group and normal control group (P<0.05or0.01). The concentration of copeptin, BNP and CRP on peripheral blood of HF group is higher than that of normal control group (P<0.05or0.01), and it is gradually increasing with the degree of severity of heart failure. An obvious negative correlation exists between the copeptin and BNP concentration and LVEF in HF group, respectively (r=-0.602and-0.561, P<0.05), however, CRP concentration has no obvious correlation with LVEF (P>0.05). When heart failure of CHD children was diagnosed according to the critical point of copeptin (1.92ng/ml) and BNP(239.5pg/ml), the areas under ROC curve are0.822and0.801respectively, the specificity87.5%and81.2%respectively, the susceptibility86.8%and89.5%respectively; but the Youden index (0.743and0.707) shows no marked difference. Using copeptin and BNP serial test and parallel test to diagnose heart failure, the specifity is94%and75%respectively, the susceptibility79%and95%respectively, but the Youden index,0.73and0.7respectively, is not so much different.Conclusion:The concentration of copeptin and BNP on peripheral blood in children with CHD companied with heart failure increased significantly, which showed an obvious negative correlation with LVEF. The copeptin and BNP concentration could be used as biomarkers of the diagnosis, the severity, and the classification of cardiac function of heart failure in CHD children.