Ozyurt Abdullah, Baykan Ali, Argun Mustafa, Pamukcu Ozge, Uzum Kazim, Narin Figen, Narin Nazmi
1Department of Pediatric Cardiology, Erciyes University Medical Faculty,Kayseri,Turkey.
2Department of Clinical Biochemistry, Erciyes University Medical Faculty,Kayseri,Turkey.
Cardiol Young. 2016 Mar;26(3):469-76. doi: 10.1017/S1047951115000438. Epub 2015 Apr 10.
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.
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.
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.
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.
本研究旨在探讨N端前脑钠肽在评估房间隔缺损和室间隔缺损患儿分流严重程度及有创血流动力学参数方面的潜在作用。
这是一项前瞻性、对照（n:62）观察性研究。对127例患儿（室间隔缺损：64例；房间隔缺损：63例）的N端前脑钠肽水平与各种有创血流动力学测量值进行相关性分析。肺循环与体循环血流量之比（Qp/Qs⩾1.5）被认为提示存在明显分流。
在两种缺损类型及对照组中，Qp/Qs⩾1.5的患者平均N端前脑钠肽值之间存在统计学显著关系。对于室间隔缺损，N端前脑钠肽水平⩾113.5 pg/ml在确定明显分流方面具有高特异性和敏感性。此外，确定房间隔缺损明显分流的切点为57.9 pg/ml。室间隔缺损患者的所有有创血流动力学参数与N端前脑钠肽水平之间存在显著正相关。而房间隔缺损患者仅在平均肺动脉压、右心室舒张末期压力及体循环压力与肺循环压力之比与N端前脑钠肽水平之间存在显著正相关。
我们的研究表明，N端前脑钠肽测量可作为确定分流意义的辅助参数。
