Comparative study of B type brain natriuretic peptide and N-terminal pro-brain natriuretic peptide in the auxiliary diagnosis of heart failure after neonatal asphyxia

Abstract

Objective To observe and compare the value of B brain natriuretic peptide(BNP) and N-terminal pro-brain natriuretic peptide(NT-proBNP) in the diagnosis of heart failure after neonatal asphyxia, and to optimize early clinical diagnosis. Methods A retrospective analysis was conducted on 124 neonatal asphyxia cases from January 2013 to October 2015, who were divided into heart failure group(53 cases) and control group(71 cases) according to whether complicated with heart failure.Comparison was conducted on BNP, NT-proBNP, cardiac troponin T (cTnT), creatine kinase isoenzyme (CK-MB) through blood sampling from femoral vein puncture within 48 h. And Logistic regression analysis was introduced into explore effecting factors of heart failure, besides, correlations between BNP, NT-proBNP and left ventricular ejection fraction (LVEF) of asphyxia children were calculated, and receiver operating characteristic curve(ROC) was introduced into analyzing of BNP and NT-proBNP for diagnostic efficacy of heart failure after neonatal asphyxia. Results Heart failure group whose BNP[(835.8±154.7) pg/ml vs. (235.4±38.5) pg/ml], NT-proBNP(25 903.8 pg/ml vs. 6 974.5 pg/ml), cTnT[(0.21±0.06)ng/ml vs. (0.11±0.03) ng/ml], CK-MB[(61.3±11.7) U/L vs. (40.8±9.5) U/L] were significantly higher than those of control group (P<0.05). Logistic regression analysis indicated BNP and NT-proBNP were closely related with newborn heart failure(ORBNP=3.013, P<0.001; ORNT-proBNP=3.808, P=0.006). BNP and NT-proBNP were both significantly negatively correlated with LVEF(rBNP=-0.650, P=0.007; rNT-proBNP=-0.721, P<0.001). The ROC curve indicated the diagnostic efficacy of BNP and NT-proBNP for heart failure after neonatal asphyxia were 0.868, 0.911, with the highest diagnosis cut-off value were 268.8 pg/ml, 3 972.3 pg/ml, respectively. Conclusion BNP and NT proBNP are specific indicators reflecting heart failure after neonatal asphyxia, and NT-proBNP with higher auxiliary diagnostic efficacy comparatively. Key words: Neonatal asphyxia; Heart failure; Brain natriuretic peptide; N-terminal pro-brain natriuretic peptide; Diagnostic efficacy