Diagnostic value of N-terminal pro-brain natriuretic peptide levels in pediatric patients with ventricular septal defect

The plasma concentrations of N-terminal pro-brain natriuretic peptide (NT-proBNP) can reflect the cardiac functions in patients with cardiac diseases. Our aim is to assess the value of NT-proBNP in the diagnosis of heart failure and evaluation of cardiac functions in pediatric patients with ventricular septal defect (VSD). The study comprised 40 children with VSD (mean age 12 ± 5 months) and 20 healthy children as a control group. Detailed echocardiographic examination was performed and the level of NT-proBNP level was measured. The plasma level of NT-proBNP was significantly higher in patients with VSD than in control subjects (P < 0.05). Also, it was significantly increased in VSD patients with congestive heart failure (CHF) than those without heart failure (P < 0.05). Moreover, NT-proBNP level increased with increasing severity of clinical symptoms. There were positive correlations between NT-proBNP level and left ventricular end diastolic diameter, left ventricular end systolic diameter, estimated systolic pulmonary artery pressure and VSD size and negative correlations with ejection fraction (EF) and fractional shortening (FS) in VSD patients with or without heart failure. The plasma levels of NT-proBNP with cutoff value of 101 fmol/ml (854 pg/ml), predicted CHF with a sensitivity of 90.0%, specificity of 80%, and area under ROC curve was 0.980. NT-proBNP level is a good marker of disease severity and correlates with echocardiographic measurements and clinical symptoms in pediatric patients with VSD.