NT-pro-BNP is sensitive to latent chronic heart failure in the patients with single ventricle physiology and Tetralogy of Fallot

  • Keiichi Hirono, Department of Pediatrics, Faculty of Medicine, University of Toyama, Japan
  • Keijirou Ibuki, Department of Pediatrics, Faculty of Medicine, University of Toyama, Japan
  • Kazuyoshi Saito, Department of Pediatrics, Faculty of Medicine, University of Toyama, Japan
  • Kazuhiro Watanabe, Department of Pediatrics, Faculty of Medicine, University of Toyama, Japan
  • Sayaka Watanabe, Department of Pediatrics, Faculty of Medicine, University of Toyama, Japan
  • Naoki Yoshimura, 1st department of surgery, Faculty of Medicine, University of Toyama, Japan
  • Fukiko Ichida, Department of Pediatrics, Faculty of Medicine, University of Toyama, Japan
  • Toshio Miyawaki, Department of Pediatrics, Faculty of Medicine, University of Toyama, Japan

    • Background: Plasma levels of brain natriuretic peptide (BNP) and N-terminal pro-BNP (NT-pro-BNP) are useful as diagnostic objective markers of chronic heart failure (CHF) due to systolic and diastolic dysfunction in adults.
    Objective: The aim of our study was to examine whether plasma levels of NT-pro-BNP correlate with clinical severity of chronic heart failure (CHF) in children with single ventricle (SV) physiology and Tetralogy of Fallot (TOF).
    Method: Eighty-four patients, 50 males and 34 females, aged 1 to 26 years (median 5 year) were enrolled. Patients were divided two groups; 46 patients with SV physiology and 38 patients with TOF. We examined NT-pro-BNP, BNP, ejection fraction and severity of heart failure in the two groups, comparing with healthy controls.
    Results: Plasma levels of NT-pro-BNP were 874±1306pg/m in SV group and 581±721pg/ml in TOF group, and which in both groups were significantly higher than healthy controls (61.9±32.1pg/ml). The plasma levels of BNP were significantly higher in groups of SV group (105.8±157.0pg/ml) and TOF group (73.5±59.5pg/ml) than healthy controls (12.8±4.2pg/ml), not strong correlation than NT-pro-BNP. NT-pro-BNP had better correlations with ejection fraction and the severity of heart failure in each group.
    Conclusions: Our study showed that the serum levels of NT-pro-BNP were more sensitive to detect heart failure than the plasma levels of BNP in children, and NT-pro-BNP is a good biomarker to monitor the CHF in the young patients with SV physiology and TOF.