Amino Terminal Fragment of Pro–B-Type Natriuretic Peptide for Complex Congenital Heart Diseases

Objective: Several studies showed that N-terminal pro-brain type natriuretic peptide (NT-pro-BNP) as the reliable marker both in diagnostic and prognostic workup of pediatric patients with congenital heart disease complicated by pulmonary hypertension. Furthermore, it has well assisted both in therapeutic and surgical management of children with congenital heart diseases. In this review, we aimed to analyze recent studies concerning the role of the NT-pro-BNP in pediatric cardiac patients with pulmonary hypertension. Methods: PubMed, Cochrane, Science Direct and Google Scholar databases were used with the searching of the following words: “amino terminal pro brain type natriuretic peptide”, “pediatric pulmonary hypertension”, “congenital heart diseases”, emphasizing on original research articles published within recent 15 years and in English language. We critically analyzed and summarized the retrieved studies. Conclusion: NT-pro-BNP remains as the reliable diagnostic and prognostic marker of pulmonary hypertension and congenital heart diseases in pediatric patients. NT-pro-BNP and BNP remain as the universal marker of cardiovascular pathology in pediatric population. Improvement of their effectiveness in diagnostic workup in patients with CHD and PH undergoing surgery needs further clarification. Key words: pediatric pulmonary hypertension, N-terminal pro brain type natriuretic peptide, congenital heart disease

Download Full-text

Plasma Atrial Natriuretic Peptide in Patients With Congenital Heart Diseases

PEDIATRICS ◽

10.1542/peds.82.4.639 ◽

1988 ◽

Vol 82 (4) ◽

pp. 639-643

Author(s):

Suguru Matsuoka ◽

Yoshihide Kurahashi ◽

Yohko Miki ◽

Masuhide Miyao ◽

Yasuhiro Yamazaki ◽

...

Keyword(s):

Atrial Natriuretic Peptide ◽

Natriuretic Peptide ◽

Congenital Heart ◽

Septal Defect ◽

Heart Diseases ◽

Ductus Arteriosus ◽

Right Atrial ◽

Congenital Heart Diseases ◽

Septal Defects ◽

Atrial Natriuretic

The plasma level of human α-atrial natriuretic peptide was measured in healthy children and patients, 1 month to 15 years of age, with congenital heart diseases. Significant increases were found in patients with a ventricular septal defect, tricuspid valve atresia, patent ductus arteriosus, and atrial septal defect but not in those with pulmonary valve stenosis or tetralogy of Fallot. The levels were significantly higher in children with ventricular septal defects (221 ± 123 pg/mL) or patent ductus arteriosus (124 ± 38 pg/mL) than in those with atrial septal defects (65 ± 42 pg/mL) (P < .01). The increased levels appeared to be correlated with enlargement of the left atrium (r = .85, P < .01) but not with the right atrial size or the mean right atrial pressure. They were higher in younger than in older healthy infants, but this age difference did not affect the results. These findings indicate that human α-atrial natriuretic peptide is released into the circulation in response to chronic atrial expansion in patients with congenital heart disease and may have an important role in volume homeostasis.

Download Full-text