Circulating B-type natriuretic peptide levels and its correlation to Qp/Qs ratio among children undergoing congenital heart surgery

Abstract

BackgroundData about different types of cardiac biomarkers is still limited in children with congenital heart disease (CHD) when compared to that in adults. We evaluated the circulating levels of B-type natriuretic peptide (BNP) in children with different types of CHD and correlated the levels with the calculated Qp/Qs ratio and the outcome of the congenital heart surgery. MethodsA prospective cross sectional- case control study was carried out on 43 pediatric patients with different types of CHD, undergoing elective cardiac surgery for shunt closure, admitted at the department of Cardiothoracic surgery-Faculty of Medicine- Assiut and Qena University hospitals. This was in addition to 17 healthy controls. All patients were diagnosed by echocardiography and cardiac catheterization. Qp/Qs ratio was calculated for every included patient. ELISA assays of plasma levels of BNP in the study groups were done. ResultsThe following findings were obtained: significant higher plasma levels of BNP among CHD children when compared with the control group (p < 0.001). Significant higher Qp/Qs ratio in children having ASD or VSD versus those had PDA (p < 0.001). Significant positive correlation between plasma BNP and Qp/Qs ratio among CHD children (r = 0.541, p < 0.001). Cut-off values for plasma BNP and Qp/Qs ratio in predicting the negative outcome were >55 pg/ml and >2.36 respectively with 100% sensitivity and 97.5% specificity. ConclusionsBNP could be considered as a valuable cardiac marker in CHD and could be a reliable marker for predicting the negative outcome of the congenital heart surgery when combined with Qp/Qs ratio.