Chen Weidan, Tang Yajie, Lu Ye, Ma Li, Chen Xinxin, Liu Techang
Cardiovascular Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Front Cardiovasc Med. 2025 Jan 15;11:1454371. doi: 10.3389/fcvm.2024.1454371. eCollection 2024.
Limited study has shown whether NT-proBNP is related to the prognosis of children wth ventricular septal defect (VSD) surgery. The study was conducted to determine the predictive value of NT-proBNP on outcomes of children with VSD surgery.
A total of 798 children with VSD surgery were enrolled, with NT-proBNP measured at preoperatively and 24-h postoperatively. The short- and mid-term clinical outcomes were recorded. Propensity scores (PS) was performed to acquire pre-op and post NT-proBNP 24-h PS-matched cohorts for comparisons between groups.
In the pre NT-proBNP PS-matched cohort, the higher NT pro-BNP group had longer hospitalization time and lower post-op 1-month EF value compared with low NT pro-BNP group (all < 0.05), and there wasn't significant difference of mechanical ventilation time, cardiopulmonary bypass (CPB) time, intensive care unit (CCU) stay, and ejection fraction (EF) values of 3 month to 12 months after surgery (all > 0.05). In the post NT-proBNP PS-matched cohort, there wasn't significant difference of mechanical ventilation time, CPB time, CCU stay, hospitalization time, and EF values of 1 month to 12 months after surgery between two groups (all > 0.05).
VSD children with higher pre NT-proBNP level had longer hospital stays after surgery than those with lower level. Pre NT-proBNP level had no effect on mechanical ventilation time, CPB time, ACC time and CCU stay and cardiac function after 3 months postoperatively. Post-op 24-h NT pro-BNP level wasn't associated with clinical outcomes.
关于N末端脑钠肽前体（NT-proBNP）是否与室间隔缺损（VSD）手术患儿的预后相关的研究有限。本研究旨在确定NT-proBNP对VSD手术患儿预后的预测价值。
共纳入798例行VSD手术的患儿，于术前及术后24小时测量NT-proBNP。记录短期和中期临床结局。采用倾向评分（PS）获得术前和术后24小时PS匹配队列，用于组间比较。
在术前NT-proBNP PS匹配队列中，与低NT-proBNP组相比，高NT-proBNP组住院时间更长，术后1个月的射血分数（EF）值更低（均P<0.05），而机械通气时间、体外循环（CPB）时间、重症监护病房（CCU）停留时间以及术后3个月至12个月的EF值差异无统计学意义（均P>0.05）。在术后NT-proBNP PS匹配队列中，两组间机械通气时间、CPB时间、CCU停留时间、住院时间以及术后1个月至12个月的EF值差异均无统计学意义（均P>0.05）。
术前NT-proBNP水平较高的VSD患儿术后住院时间比水平较低者更长。术前NT-proBNP水平对机械通气时间、CPB时间、主动脉阻断时间和CCU停留时间以及术后3个月后的心脏功能无影响。术后24小时NT-proBNP水平与临床结局无关。
