title: Aminoterminal brain natriuretic peptide levels in children and adolescents after Fontan operation correlate with congestive heart failure.
abstract: The aim of this study was to generate normal values of amino-terminal pro-brain natriuretic peptide (NT-pro-BNP) in children and adolescents after Fontan operation without congestive heart failure (CHF) and to test the hypothesis that plasma levels of NT-pro-BNP correlate with the clinical severity of CHF. NT-pro-BNP plasma levels of 59 consecutive patients, with a median age of 8.4 years, after Fontan operation were measured using an automated enzyme immunoassay. The 97.5th percentile of NT-pro-BNP in patients without CHF was 282.3 pg/ml. The severity of heart failure was quantified by a pediatric cardiologist using the New York University Pediatric Heart Failure Index (NYUPHFI). NT-pro-BNP levels correlated with the NYUPHFI (p = 0.001). In patients with CHF (14/59) the NT-pro-BNP levels were significantly higher (median, 399 pg/ml; range, 140-5440 pg/ml) than in patients without CHF (median, 96 pg/ml; range, 11-376 pg/ml). NT-pro-BNP levels of patients with Fontan circulation without CHF are similar to those of healthy children. Plasma NT-pro-BNP concentrations correlate with the severity of CHF in children and adolescents after Fontan operation. Plasma NT-pro-BNP levels can help clinicians in the detection of CHF in pediatric patients with Fontan circulation.
authors.affiliation: Pediatric Cardiology, Children's Heart Center Linz, Krankenhausstrausse 26, A4020 Linz, Austria. elechner@aon.at
authors.forename: Evelyn
authors.initials: E
authors.lastname: Lechner
authors.forename: Roland
authors.initials: R
authors.lastname: Gitter
authors.forename: Rudolf
authors.initials: R
authors.lastname: Mair
authors.forename: Miklos
authors.initials: M
authors.lastname: Pinter
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Schreier-Lechner
authors.forename: David
authors.initials: D
authors.lastname: Vondrys
authors.forename: Gerald
authors.initials: G
authors.lastname: Tulzer
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D018729:Fontan Procedure; D006333:Heart Failure / Q000097:blood* / Q000601:surgery*; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011446:Prospective Studies; D012016:Reference Values; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain