title: Levels of brain natriuretic peptide in children with right ventricular overload due to congenital cardiac disease.
abstract: OBJECTIVE
  To evaluate the role of the concentration of brain natriuretic peptide in the plasma, and its correlation with haemodynamic right ventricular parameters, in children with overload of the right ventricle due to congenital cardiac disease.
  
  
  METHODS
  We studied 31 children, with a mean age of 4.8 years, with volume or pressure overload of the right ventricle caused by congenital cardiac disease. Of the patients, 19 had undergone surgical biventricular correction of tetralogy of Fallot, 11 with pulmonary stenosis and 8 with pulmonary atresia, and 12 patients were studied prior to operations, 7 with atrial septal defects and 5 with anomalous pulmonary venous connections. We measured brain natriuretic peptide using Triage(R), from Biosite, United States of America. We determined end-diastolic pressures of the right ventricle, and the peak ratio of right to left ventricular pressures, by cardiac catheterization and correlated them with concentrations of brain natriuretic peptide in the plasma.
  
  
  RESULTS
  The mean concentrations of brain natriuretic peptide were 87.7, with a range from 5 to 316, picograms per millilitre. Mean end-diastolic pressure in the right ventricle was 5.6, with a range from 2 to 10, millimetres of mercury, and the mean ratio of right to left ventricular pressure was 0.56, with a range from 0.24 to 1.03. There was a positive correlation between the concentrations of brain natriuretic peptide and the ratio of right to left ventricular pressure (r equal to 0.7844, p less than 0.0001) in all patients. These positive correlations remained when the children with tetralogy of Fallot, and those with atrial septal defects or anomalous pulmonary venous connection, were analysed as separate groups. We also found a weak correlation was shown between end-diastolic right ventricular pressure and concentrations of brain natriuretic peptide in the plasma (r equal to 0.5947, p equal to 0.0004).
  
  
  CONCLUSIONS
  There is a significant correlation between right ventricular haemodynamic parameters and concentrations of brain natriuretic peptide in the plasma of children with right ventricular overload due to different types of congenital cardiac disease. The monitoring of brain natriuretic peptide may provide a non-invasive and safe quantitative follow up of the right ventricular pressure and volume overload in these patients.
authors: Herzzentrum, Klinik und Poliklinik für Kinderkardiologie, Hamburg, Germany. mir@uke.uni-hamburg.de
authors: Thomas S
authors: TS
authors: Mir
authors: Jan
authors: J
authors: Falkenberg
authors: Bernd
authors: B
authors: Friedrich
authors: Urda
authors: U
authors: Gottschalk
authors: Throng Phi
authors: TP
authors: Lê
authors: Stephanie
authors: S
authors: Laer
authors: Jochen
authors: J
authors: Weil
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D006801:Humans; D007223:Infant; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011379:Prognosis; D012720:Severity of Illness Index; D018497:Ventricular Dysfunction, Right / Q000097:blood* / Q000209:etiology / Q000503:physiopathology; D017725:Ventricular Pressure / Q000502:physiology
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain