Welisch Eva, Kleesiek Knut, Haas Nikolaus, Norozi Kambiz, Rauch Ralf, Filler Guido
Department of Paediatric Cardiology, Ruhr University Bochum, North Rhine Westphalia, 32545, Germany.
Int J Pediatr. 2009;2009:241376. doi: 10.1155/2009/241376. Epub 2010 Feb 24.
Background. Serum concentration of NT-proBNP correlates well with the severity of cardiac disease in adults. Few studies have been performed on the applicability of NT-proBNP for monitoring children with congenital heart disease. Objective. To assess the potential of NT-proBNP for monitoring the success of interventions in children with stenotic cardiac lesions. Methods. NT-proBNP was measured in 42 children aged 1 day to 17 years (y) before and 6 to 12 weeks after surgical or interventional correction of obstructive lesions of the heart. Comparison is made with the clinical status and echocardiographic data of the child. Results. NT-proBNP levels (median 280, range 10-263,000 pg/mL) were above the reference value in all but 6 patients (pts) prior to the intervention. Higher levels were found in more compromised patients. The 35 children with clinical improvement after the procedure showed a decline of their NT-proBNP level in all but 4 patients, whose levels remained unchanged. Five patients with unchanged gradients despite a therapeutic intervention also demonstrated unchanged NT-proBNP levels after the intervention. Thus, the success rate of the procedure correlated well to clinical and echocardiographic findings. Conclusion. NT-proBNP can be used to assess the efficiency of an intervention.
背景。成人血清NT-proBNP浓度与心脏疾病严重程度密切相关。关于NT-proBNP在监测先天性心脏病儿童中的适用性研究较少。目的。评估NT-proBNP在监测患有狭窄性心脏病变儿童干预治疗成功与否方面的潜力。方法。对42例年龄在1天至17岁的儿童在心脏梗阻性病变手术或介入矫正术前及术后6至12周测定NT-proBNP。并与儿童的临床状况及超声心动图数据进行比较。结果。除6例患者外,所有患者干预前NT-proBNP水平(中位数280,范围10 - 263,000 pg/mL)均高于参考值。病情越严重的患者NT-proBNP水平越高。术后临床症状改善的35例儿童中,除4例患者NT-proBNP水平未变化外,其余患者NT-proBNP水平均下降。5例尽管接受了治疗性干预但梯度未改变的患者,干预后NT-proBNP水平也未改变。因此,手术成功率与临床及超声心动图结果密切相关。结论。NT-proBNP可用于评估干预治疗的效果。