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Does N-terminal pro-brain natriuretic peptide correlate with measured shunt fraction in children with septal defects?*

  • Abdullah Ozyurt (a1), Ali Baykan (a1), Mustafa Argun (a1), Ozge Pamukcu (a1), Kazim Uzum (a1), Figen Narin (a2) and Nazmi Narin (a1)...



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.


Corresponding author

Correspondence to: A. Ozyurt, MD, Department of Pediatric Cardiology, Erciyes University Medical Faculty, 38039 Kayseri, Turkey. Tel: +90 352 207 6666, ext. 25036; Fax: +90 324 223 0722; E-mail:


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The present study has been presented for Oral Presentation at the 48th Annual Meeting of the Association for European Paediatric and Congenital Cardiology, Helsinki, 21–24 May, 2014.



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