title: N-terminal pro-brain natriuretic peptide as a predictor of reoperation in children with surgically corrected tetralogy of fallot.
abstract: BACKGROUND
  Most patients with surgically corrected tetralogy of Fallot (TOF) are faced with multiple residua and sequelae such as pulmonary regurgitation (PR), resulting in reoperation for pulmonary valve replacement (PVR). Plasma brain natriuretic peptide (BNP) level and serum N-terminal pro-BNP (NT-pro-BNP) level are useful as diagnostic objective markers of chronic heart failure (CHF). The aim of the study was to examine whether these markers have predictive ability for reoperation in children with surgically corrected TOF.
  
  
  RESULTS
  Fifty-eight patients (38 male, 20 female) aged 1-18 years (median, 7 years) were enrolled. Serum NT-pro-BNP in TOF patients was significantly higher than in age-matched hospital controls without CHF (359.5±449.7pg/ml vs. 86.1±45.1pg/ml, respectively; P<0.0001). BNP and NT-pro-BNP had a better correlation with CHF index, RVEDP, and LVEDV in TOF groups. Children with surgically corrected TOF who had indication for PVR had higher BNP and NT-pro-BNP and more severe PR than those without indication for PVR. On multivariate logistic regression analysis, NT-pro-BNP was the strongest predictor for reoperation in patients with surgically corrected TOF. Area under the curve of NT-pro-BNP for reoperation was 0.950 (P<0.001) with a sensitivity of 88.9% and specificity of 91.8%.
  
  
  CONCLUSIONS
  NT-pro-BNP is a good biomarker for monitoring CHF, and is a good predictor of PVR in children with surgically repaired TOF.
authors: Department of Pediatrics, Graduate School of Medicine, University of Toyama.
authors: Keiichi
authors: K
authors: Hirono
authors: Michikazu
authors: M
authors: Sekine
authors: Noriko
authors: N
authors: Shiba
authors: Shirou
authors: S
authors: Hayashi
authors: Hideyuki
authors: H
authors: Nakaoka
authors: Keijiro
authors: K
authors: Ibuki
authors: Kazuyoshi
authors: K
authors: Saito
authors: Kazuhiro
authors: K
authors: Watanabe
authors: Sayaka
authors: S
authors: Ozawa
authors: Tomonori
authors: T
authors: Higuma
authors: Naoki
authors: N
authors: Yoshimura
authors: Isao
authors: I
authors: Kitajima
authors: Fukiko
authors: F
authors: Ichida
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D012086:Reoperation; D013771:Tetralogy of Fallot / Q000097:blood* / Q000473:pathology / Q000601:surgery*
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain