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NT-proBNP levels as a predictor of higher left ventricular end-diastolic pressure in children with small perimembranous ventricular septal defect

Published online by Cambridge University Press:  20 April 2023

Putria R. Apandi Open the ORCID record for Putria R. Apandi [Opens in a new window] ,
Mulyadi M. Djer ,
Rahmat B. Kuswiyanto ,
Elrika A. Wijaya ,
Bagus Artiko  and
Sri E. Rahayuningsih Open the ORCID record for Sri E. Rahayuningsih [Opens in a new window]
Putria R. Apandi*
Affiliation:
Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia Department of Child Health, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
Mulyadi M. Djer
Affiliation:
Department of Child Health, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
Rahmat B. Kuswiyanto
Affiliation:
Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
Elrika A. Wijaya
Affiliation:
Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
Bagus Artiko
Affiliation:
Department of Child Health, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
Sri E. Rahayuningsih
Affiliation:
Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
*
Author for correspondence: Putria R. Apandi, Department of Child Health, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin General Hospital, Jalan Pasteur No. 38, Bandung, West Java 40161, Indonesia. Tel: +6228164870962. E-mail: putriadirgantara@gmail.com
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Abstract

Introduction:

The decision to close small ventricular septal defect is still controversial. Previous study showed that ventricular dysfunction in adulthood is correlated with small perimembranous ventricular septal defect. N terminal pro B-type natriuretic peptide (NT-proBNP) is a neurohormone secreted primarily from the ventricles in response to increased left and right ventricular pressure and volume load. The left ventricular end-diastolic pressure will reflect ventricular performance. This study aimed to evaluate the correlation between left ventricular end-diastolic pressure and the NT-proBNP in children with small perimembranous ventricular septal defect.

Materials and Methods:

Level of NT-proBNP in 41 patients with small perimembranous ventricular septal defect was measured before transcatheter closure procedure. We also measured the left ventricular end-diastolic pressure in each patients during catheterisation. We investigated the value of NT-proBNP in patients with small perimembranous ventricular septal defect and its correlation with the level of left ventricular end-diastolic pressure

Result:

We found positive correlation between NT-proBNP and left ventricular end-diastolic pressure (r = 0.278, p = 0.046). The median of NT-proBNP at left ventricular end-diastolic pressure < 10 was lower than at left ventricular end-diastolic pressure ≥ 10 (0.87 ng/ml versus 1.83 ng/ml, p = 0.023). The results of the NT-proBNP diagnostic test for predicting left ventricular end-diastolic pressure ≥ 10 using Receiver Operating Characteristic (ROC) analysis showed the area under the curve value of 0.715 (95% CI: 0.546–0.849). The cut-off value >0.99 ng/ml of NT-proBNP has 75.0% sensitivity and 72.2% specifity.

Conclusion:

Level of NT-proBNP higher than 0.99 ng/ml was correlated significantly with left ventricular end-diastolic pressure ≥10 in children with small perimembranous ventricular septal defect.

Keywords

Ventricular septal defectNT-proBNPchildrenpediatric
Type
Original Article
Information
Cardiology in the Young , Volume 33 , Issue 12 , December 2023 , pp. 2604 - 2609
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Copyright
© The Author(s), 2023. Published by Cambridge University Press

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