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Does N-terminal pro-brain natriuretic peptide correlate with measured shunt fraction in children with septal defects?*

Published online by Cambridge University Press:  10 April 2015

Abdullah Ozyurt ,
Ali Baykan ,
Mustafa Argun ,
Ozge Pamukcu ,
Kazim Uzum ,
Figen Narin  and
Nazmi Narin
Abdullah Ozyurt*
Affiliation:
Department of Pediatric Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey
Ali Baykan
Affiliation:
Department of Pediatric Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey
Mustafa Argun
Affiliation:
Department of Pediatric Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey
Ozge Pamukcu
Affiliation:
Department of Pediatric Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey
Kazim Uzum
Affiliation:
Department of Pediatric Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey
Figen Narin
Affiliation:
Department of Clinical Biochemistry, Erciyes University Medical Faculty, Kayseri, Turkey
Nazmi Narin
Affiliation:
Department of Pediatric Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey
*
Correspondence to: A. Ozyurt, MD, Department of Pediatric Cardiology, Erciyes University Medical Faculty, 38039 Kayseri, Turkey. Tel: +90 352 207 6666, ext. 25036; Fax: +90 324 223 0722; E-mail: duruozyurt@yahoo.com.tr
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Abstract

Background

The aim of this study was to investigate the potential role of N-terminal pro-brain natriuretic peptide in the assessment of shunt severity and invasive haemodynamic parameters in children with atrial septal defects and ventricular septal defects.

Methods

This is a prospective, controlled (n:62), observational study. Correlation analysis was performed between N-terminal pro-brain natriuretic peptide levels and various invasive haemodynamic measurements in 127 children (ventricular septal defect: 64; atrial septal defect: 63). A ratio of pulmonary to systemic blood flow (Qp/Qs⩾1.5) was considered to indicate a significant shunt.

Results

Statistically significant relationship was found between the mean N-terminal pro-brain natriuretic peptide values of the patients, with Qp/Qs⩾1.5 in both defect types and control group. For ventricular septal defect, N-terminal pro-brain natriuretic peptide level⩾113.5 pg/ml was associated with high specificity and sensitivity for determining the significant shunt. In addition, the cut-off point for determining the significant shunt for atrial septal defect was 57.9 pg/ml. Significant positive correlation was found between all invasive haemodynamic parameters and N-terminal pro-brain natriuretic peptide levels in patients with ventricular septal defects. Whereas significant positive correlation was found only between mean pulmonary artery pressure, right ventricular end-diastolic pressure, and systemic pressure to pulmonary pressure ratio and N-terminal pro-brain natriuretic peptide levels in patients with atrial septal defects.

Conclusion

Our study demonstrated that the N-terminal pro-brain natriuretic peptide measurements could be used as a supporting parameter in determining significance of the shunt.

Keywords

Atrial septal defectbrain natriuretic peptidecardiac catheterizationheart failureventricular septal defect
Type
Original Articles
Information
Cardiology in the Young , Volume 26 , Issue 3 , March 2016 , pp. 469 - 476
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Copyright
© Cambridge University Press 2015 

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Footnotes

*

The present study has been presented for Oral Presentation at the 48th Annual Meeting of the Association for European Paediatric and Congenital Cardiology, Helsinki, 21–24 May, 2014.

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