Key result
Plasma BNP levels were significantly higher in children with CHD versus controls (p<0.001), and a cut-off >55 pg/ml predicted negative surgical outcomes with 100% sensitivity and 97.5% specificity.
Why the study?
Do circulating BNP levels correlate with Qp/Qs ratio and predict negative outcomes in children undergoing congenital heart surgery?
Case-Control (n=60)
Yes
Do circulating BNP levels correlate with Qp/Qs ratio and predict negative outcomes in children undergoing congenital heart surgery?
Plasma BNP levels correlate significantly with Qp/Qs ratio and, when combined, can reliably predict negative outcomes in children undergoing congenital heart surgery.
Answers are grounded in this paper and cite their sources.
BNP may support risk stratification before pediatric CHD surgery; hypothesis-generating and should not yet change practice.
Data about different types of cardiac biomarkers is still limited in children with congenital heart disease (CHD) when compared to that in adults. We evaluated the circulating levels of B-type natriuretic peptide (BNP) in children with different types of CHD and correlated the levels with the calculated Qp/Qs ratio and the outcome of the congenital heart surgery. A prospective cross sectional- case control study was carried out on 43 pediatric patients with different types of CHD, undergoing elective cardiac surgery for shunt closure, admitted at the department of Cardiothoracic surgery-Faculty of Medicine- Assiut and Qena University hospitals. This was in addition to 17 healthy controls. All patients were diagnosed by echocardiography and cardiac catheterization. Qp/Qs ratio was calculated for every included patient. ELISA assays of plasma levels of BNP in the study groups were done. The following findings were obtained: significant higher plasma levels of BNP among CHD children when compared with the control group (p < 0.001). Significant higher Qp/Qs ratio in children having ASD or VSD versus those had PDA (p < 0.001). Significant positive correlation between plasma BNP and Qp/Qs ratio among CHD children (r = 0.541, p < 0.001). Cut-off values for plasma BNP and Qp/Qs ratio in predicting the negative outcome were >55 pg/ml and >2.36 respectively with 100% sensitivity and 97.5% specificity. BNP could be considered as a valuable cardiac marker in CHD and could be a reliable marker for predicting the negative outcome of the congenital heart surgery when combined with Qp/Qs ratio.
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Farouk et al. (2017) conducted a case-control in Congenital heart disease (n=60). Congenital heart disease vs. Healthy controls was evaluated on Plasma levels of BNP and prediction of negative surgical outcome (100% sensitivity and 97.5% specificity for BNP >55 pg/ml, p=<0.001). Plasma BNP levels were significantly higher in children with CHD versus controls (p<0.001), and a cut-off >55 pg/ml predicted negative surgical outcomes with 100% sensitivity and 97.5% specificity.
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