title: Plasma brain natriuretic peptide and the evaluation of volume overload in infants and children with congenital heart disease.
abstract: This study was designed to explore whether it was possible to evaluate the severity of VSD, PDA, and ASD by measuring brain natriuretic peptide (BNP) levels. We also investigated normal BNP levels in children to provide a baseline for our study. We measured BNP levels in 253 normal children, including 11 normal neonates, and in 91 VSD patients, 29 PDA patients, and 34 ASD patients. BNP levels showed no age-related differences in normal children (the mean value: 5.3 +/- 3.8 pg/ml). In the healthy neonates, BNP levels rose from 10.4 +/- 11.9 pg/ml in cord blood to 118.8 +/- 83.2 pg/ml on day 0, then fell to 15.3 +/- 7.8 pg/ml by day 7. In VSD and PDA patients, BNP levels correlated significantly with Qp/Qs, LVEDV, and peak RVP/LVP. In ASD patients, BNP levels correlated with Qp/Qs and RVEDV. Especially, in VSD patients, as an index corresponding to 1.5-2.0 of the Qp/Qs ratio, BNP levels of 20-35 pg/ml were found to be best with regard to both sensitivity and specificity. In the healthy neonates, BNP levels changed rapidly after birth. In VSD, PDA, and ASD patients, BNP levels were well-correlated with the severity of the disease. Especially, in VSD patients, it that appears BNP levels may be useful in evaluating surgical indications, with 20-35 pg/ml levels being the appropriate cut-off value.
authors: Department of Pediatrics, Okayama University Graduate School of Medicine and Dentistry, Okayama 700 8558, Japan. ykunys@hotmail.com
authors: Yoko
authors: Y
authors: Kunii
authors: Masahiro
authors: M
authors: Kamada
authors: Shinichi
authors: S
authors: Ohtsuki
authors: Tohru
authors: T
authors: Araki
authors: Kohichi
authors: K
authors: Kataoka
authors: Misao
authors: M
authors: Kageyama
authors: Naomi
authors: N
authors: Nakagawa
authors: Yoshiki
authors: Y
authors: Seino
mesh_terms: D000293:Adolescent; D015415:Biomarkers; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D005260:Female; D006330:Heart Defects, Congenital / Q000097:blood* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D013318:Stroke Volume; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain