635 Cardiac Troponin I and Natriuretic Peptide Nt-Probnp in Children with Operated Congenital Cardiac Malformations

Abstract

Background and aim: Cardiac troponin I (cTnI) and natriuretic peptide NT-proBNP are useful biomarkers in the evaluation of the sick heart. We aimed to detect a potential early postoperative myocardial disease in children with congenital cardiac malformations undergoing heart surgery. Methods: 24 patients aged between 6 months and 3 years with operated cyanogenic cardiac malformations and 17 control subjects were studied. cTnI was determined using an immunochemical method with detection by Immulite electrochemiluminescence (ECLIA); reference values < 0.2 ng/ml. Serum NT-proBNP levels were assessed by the ELISA immunoenzymatic method (Enzyme-linked Immunosorbent Assay) using a standardized kit containing monoclonal antibodies that recognize epitopes located in the NT-proBNP portion. Serum was taken from patients within 24 hours post-operation. Results: The mean cTnI value in patients with congenital heart diseases was 10.23 ng/ml, compared to those of the controls situated below the detection limit < 0.2 ng/ml. 50-fold higher cTnI values were found in patients compared to healthy subjects, suggesting myocardial injury. The mean value of NT-proBNP was 30.42 fmol/ml. There was a positive correlation between cTnI and NT-proBNP levels in patients with congenital cardiac malformations: cTnI tended to decrease with the increase in NT-proBNP. Conclusions: cTnI has increased values in the first 24 postoperative hours in children with congenital cardiac malformations. There is a positive correlation between cTnI and NT-proBNP values suggesting the association of an early postoperative myocardial dysfunction in children with heart surgery.