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Levels of brain natriuretic peptide in children with right ventricular overload due to congenital cardiac disease

Published online by Cambridge University Press:  13 July 2005

Thomas S. Mir ,
Jan Falkenberg ,
Bernd Friedrich ,
Urda Gottschalk ,
Throng Phi Lê ,
Stephanie Laer  and
Jochen Weil
Thomas S. Mir
Affiliation:
Herzzentrum, Klinik und Poliklinik für Kinderkardiologie, Hamburg, Germany
Jan Falkenberg
Affiliation:
Herzzentrum, Klinik und Poliklinik für Kinderkardiologie, Hamburg, Germany
Bernd Friedrich
Affiliation:
Herzzentrum, Klinik und Poliklinik für Kinderkardiologie, Hamburg, Germany
Urda Gottschalk
Affiliation:
Herzzentrum, Klinik und Poliklinik für Kinderkardiologie, Hamburg, Germany
Throng Phi Lê
Affiliation:
Herzzentrum, Klinik und Poliklinik für Kinderkardiologie, Hamburg, Germany
Stephanie Laer
Affiliation:
Zentrum für Experimentelle Medizin, Institut für Experimentelle und Klinische Pharmakologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
Jochen Weil
Affiliation:
Herzzentrum, Klinik und Poliklinik für Kinderkardiologie, Hamburg, Germany
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Abstract

Objective: To evaluate the role of the concentration of brain natriuretic peptide in the plasma, and its correlation with haemodynamic right ventricular parameters, in children with overload of the right ventricle due to congenital cardiac disease. Methods: We studied 31 children, with a mean age of 4.8 years, with volume or pressure overload of the right ventricle caused by congenital cardiac disease. Of the patients, 19 had undergone surgical biventricular correction of tetralogy of Fallot, 11 with pulmonary stenosis and 8 with pulmonary atresia, and 12 patients were studied prior to operations, 7 with atrial septal defects and 5 with anomalous pulmonary venous connections. We measured brain natriuretic peptide using Triage®, from Biosite, United States of America. We determined end-diastolic pressures of the right ventricle, and the peak ratio of right to left ventricular pressures, by cardiac catheterization and correlated them with concentrations of brain natriuretic peptide in the plasma. Results: The mean concentrations of brain natriuretic peptide were 87.7, with a range from 5 to 316, picograms per millilitre. Mean end-diastolic pressure in the right ventricle was 5.6, with a range from 2 to 10, millimetres of mercury, and the mean ratio of right to left ventricular pressure was 0.56, with a range from 0.24 to 1.03. There was a positive correlation between the concentrations of brain natriuretic peptide and the ratio of right to left ventricular pressure (r equal to 0.7844, p less than 0.0001) in all patients. These positive correlations remained when the children with tetralogy of Fallot, and those with atrial septal defects or anomalous pulmonary venous connection, were analysed as separate groups. We also found a weak correlation was shown between end-diastolic right ventricular pressure and concentrations of brain natriuretic peptide in the plasma (r equal to 0.5947, p equal to 0.0004). Conclusion: There is a significant correlation between right ventricular haemodynamic parameters and concentrations of brain natriuretic peptide in the plasma of children with right ventricular overload due to different types of congenital cardiac disease. The monitoring of brain natriuretic peptide may provide a non-invasive and safe quantitative follow up of the right ventricular pressure and volume overload in these patients.

Keywords

Brain natriuretic peptidepaediatricsventricular function
Type
Original Article
Information
Cardiology in the Young , Volume 15 , Issue 4 , August 2005 , pp. 396 - 401
Copyright
© 2005 Cambridge University Press

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