title: Does N-terminal pro-brain natriuretic peptide correlate with measured shunt fraction in children with septal defects?
abstract: BACKGROUND
  The aim of this study was to investigate the potential role of N-terminal pro-brain natriuretic peptide in the assessment of shunt severity and invasive haemodynamic parameters in children with atrial septal defects and ventricular septal defects.
  
  
  METHODS
  This is a prospective, controlled (n:62), observational study. Correlation analysis was performed between N-terminal pro-brain natriuretic peptide levels and various invasive haemodynamic measurements in 127 children (ventricular septal defect: 64; atrial septal defect: 63). A ratio of pulmonary to systemic blood flow (Qp/Qs⩾1.5) was considered to indicate a significant shunt.
  
  
  RESULTS
  Statistically significant relationship was found between the mean N-terminal pro-brain natriuretic peptide values of the patients, with Qp/Qs⩾1.5 in both defect types and control group. For ventricular septal defect, N-terminal pro-brain natriuretic peptide level⩾113.5 pg/ml was associated with high specificity and sensitivity for determining the significant shunt. In addition, the cut-off point for determining the significant shunt for atrial septal defect was 57.9 pg/ml. Significant positive correlation was found between all invasive haemodynamic parameters and N-terminal pro-brain natriuretic peptide levels in patients with ventricular septal defects. Whereas significant positive correlation was found only between mean pulmonary artery pressure, right ventricular end-diastolic pressure, and systemic pressure to pulmonary pressure ratio and N-terminal pro-brain natriuretic peptide levels in patients with atrial septal defects.
  
  
  CONCLUSIONS
  Our study demonstrated that the N-terminal pro-brain natriuretic peptide measurements could be used as a supporting parameter in determining significance of the shunt.
authors: 1Department of Pediatric Cardiology, Erciyes University Medical Faculty,Kayseri,Turkey.
authors: Abdullah
authors: A
authors: Ozyurt
authors: 1Department of Pediatric Cardiology, Erciyes University Medical Faculty,Kayseri,Turkey.
authors: Ali
authors: A
authors: Baykan
authors: 1Department of Pediatric Cardiology, Erciyes University Medical Faculty,Kayseri,Turkey.
authors: Mustafa
authors: M
authors: Argun
authors: 1Department of Pediatric Cardiology, Erciyes University Medical Faculty,Kayseri,Turkey.
authors: Ozge
authors: O
authors: Pamukcu
authors: 1Department of Pediatric Cardiology, Erciyes University Medical Faculty,Kayseri,Turkey.
authors: Kazim
authors: K
authors: Uzum
authors: 2Department of Clinical Biochemistry, Erciyes University Medical Faculty,Kayseri,Turkey.
authors: Figen
authors: F
authors: Narin
authors: 1Department of Pediatric Cardiology, Erciyes University Medical Faculty,Kayseri,Turkey.
authors: Nazmi
authors: N
authors: Narin
mesh_terms: D015415:Biomarkers / Q000097:blood; D006328:Cardiac Catheterization; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000503:physiopathology* / Q000601:surgery; D006345:Heart Septal Defects, Ventricular / Q000503:physiopathology* / Q000601:surgery; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011446:Prospective Studies; D012372:ROC Curve; D014421:Turkey
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain
keywords: Atrial septal defect; brain natriuretic peptide; cardiac catheterization; heart failure; ventricular septal defect