title: Value of brain natriuretic peptide in the perioperative follow-up of children with valvular disease.
abstract: OBJECTIVE
  To characterize N-terminal pro-brain natriuretic peptide (N-proBNP) and troponin I (TnI) profile following mitral and/or aortic valve surgery and to evaluate correlations with echocardiography measures and outcome criteria.
  
  
  METHODS
  Prospective cross-controlled study in a university children's hospital.
  
  
  METHODS
  Twenty children with acquired valvular disease requiring valvular surgery.
  
  
  METHODS
  We prospectively studied clinical, biochemical, and echocardiographic characteristics at baseline and 6, 12, 24 h and 3-4 weeks postoperatively.
  
  
  RESULTS
  TnI peaked 6 h after surgery and remained elevated during the first 24 h. N-proBNP was significantly lower 3-4 weeks after surgery than during the perioperative period. Overall, N-proBNP was correlated with the Pediatric Heart Failure Index, left ventricle shortening fraction, left atrium to aorta ratio, left ventricle mass index, end-systolic wall stress, and with outcome measures such as inotropic score, duration of inotropic support, and ICU length of stay. Preoperative N-proBNP was significantly more elevated in patients with complicated outcome than in patients with uneventful postoperative course.
  
  
  CONCLUSIONS
  In pediatric valvular patients, perioperative N-proBNP is a promising risk stratification predicting factor. It is correlated with evolutive echocardiographic measures, need for inotropic support, and ICU length of stay.
authors.affiliation: ICU Research Laboratory, Department of Microbiology and Molecular Medicine, University of Geneva Medical School, CMU, Rue Michel-Servet 1, Geneva 4, Switzerland. Pierre.Tissieres@medecine.unige.ch
authors.forename: Pierre
authors.initials: P
authors.lastname: Tissières
authors.forename: Eduardo
authors.initials: E
authors.lastname: da Cruz
authors.forename: Walid
authors.initials: W
authors.lastname: Habre
authors.forename: Yacine
authors.initials: Y
authors.lastname: Aggoun
authors.forename: Noury
authors.initials: N
authors.lastname: Mensi
authors.forename: Afksendyios
authors.initials: A
authors.lastname: Kalangos
authors.forename: Maurice
authors.initials: M
authors.lastname: Beghetti
mesh_terms: D015415:Biomarkers / Q000097:blood*; D002648:Child; D004452:Echocardiography; D006349:Heart Valve Diseases / Q000097:blood* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011446:Prospective Studies; D012372:ROC Curve; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D019210:Troponin I / Q000097:blood
chemical_list: D015415:Biomarkers; D019210:Troponin I; D020097:Natriuretic Peptide, Brain