Why the study?
Does plasma BNP level correlate with hemodynamics and identify the need for intervention in pediatric patients with atrial or ventricular septal defect?
Does plasma BNP level correlate with hemodynamics and identify the need for intervention in pediatric patients with atrial or ventricular septal defect?
A plasma BNP level > 15 pg/mL is highly specific for identifying a Qp/Qs ratio > 1.5 in children with septal defects, potentially aiding in selecting patients for intervention.
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BNP may aid noninvasive shunt assessment in pediatric septal defects; hypothesis-generating and should not yet change practice.
In this study, we investigated the relationship between plasma B-type natriuretic peptide (BNP) levels and hemodynamics from cardiac catheterization in pediatric patients with atrial or ventricular septal defect. A total of 59 patients were studied including 80% of patients had Qp/Qs > 1.5 and 25% of patients had pulmonary hypertension. The mean BNP value and BNP z-score were 10.9 ± 11.2 pg/mL and -0.28 ± 1.7 (-2.85 to 3.29), respectively. There was a statistically significant linear correlation between BNP value and the size of defects (r = 0.303, p = 0.002) and a trend toward to positive correlation between BNP value and Qp/Qs ratio (r = 0.183, p = 0.166) among all patients. To identify patients with a Qp/Qs ratio >1.5, the sensitivity and specificity were 28%, 100% in all patients at a plasma BNP cut-off point of 15 pg/mL. We concluded that a BNP > 15 pg/mL would help identify patients who need further intervention.
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Jan et al. (2012) studied this question.
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