Volume 11, Issue 1 (2025)
CJP 2025, 11(1): e26 |
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Mirzaei Ilali H, Hosseini S M, Babazadeh K, Ghorbani H, Zamani H, Gholinia H. Comparison of Serum Brain Natriuretic Peptide Levels Before and After Interventional Catheterization or Corrective Cardiac Surgery in Children with Left-to-Right Shunt Congenital Heart Disease. CJP 2025; 11 (1)
URL: http://caspianjp.ir/article-1-287-en.html
URL: http://caspianjp.ir/article-1-287-en.html
Hamidreza Mirzaei Ilali 
, Seyyedeh Mahsa Hosseini , Kazem Babazadeh * , Housein Ghorbani , Hassan Zamani , Hemmat Gholinia
, Seyyedeh Mahsa Hosseini , Kazem Babazadeh * , Housein Ghorbani , Hassan Zamani , Hemmat Gholinia
Assistant Professor of Pediatric Cardiology, Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, IR Iran , kbabazadeh@hotmail.com
Abstract: (7 Views)
Background and Objective: Elevated serum brain natriuretic peptide (BNP) levels have been associated with congenital heart disease (CHD) involving left-to-right shunt lesions. This study aimed to compare serum BNP concentrations before and after interventional catheterization or corrective cardiac surgery in children with acyanotic CHD.
Methods: This cross-sectional study included children aged 6 months to 14 years with acyanotic CHD and left-to-right shunt who were admitted to Ayatollah Rouhani Hospital (Babol) and Shahid Modarres Hospital (Tehran) in 2018. Patients with non-cardiac comorbidities were excluded. All underwent either interventional catheterization or corrective cardiac surgery. Serum BNP levels were measured at baseline and 48 hours post-intervention. Echocardiography was performed by a pediatric cardiologist at the same time points. Data were analyzed using paired t-test and Wilcoxon in SPSS-v22, with p<0.05 considered statistically significant.
Findings: In a group of 50 children (mean age 43.48 ± 42.74 months), mean serum BNP levels increased significantly after intervention (from 130 to 1,475 pg/mL; p<0.001), while mean ejection fraction (EF) decreased from 68% to 62% (p<0.001). The post-intervention BNP elevation was significant in both moderate and severe shunt groups (p<0.001). Pre-intervention BNP was higher in patients with severe shunts (143.9 pg/mL) than in those with moderate shunts (p=0.02). After intervention, BNP remained markedly higher in the severe group (1,900.7 pg/mL; p<0.001).
Conclusion: Serum BNP measurement 48 hours after intervention provides a useful, though limited, indicator of hemodynamic status. Given its correlation with shunt severity, BNP may serve as a reliable adjunct biomarker for postoperative assessment and follow-up in pediatric CHD.
Methods: This cross-sectional study included children aged 6 months to 14 years with acyanotic CHD and left-to-right shunt who were admitted to Ayatollah Rouhani Hospital (Babol) and Shahid Modarres Hospital (Tehran) in 2018. Patients with non-cardiac comorbidities were excluded. All underwent either interventional catheterization or corrective cardiac surgery. Serum BNP levels were measured at baseline and 48 hours post-intervention. Echocardiography was performed by a pediatric cardiologist at the same time points. Data were analyzed using paired t-test and Wilcoxon in SPSS-v22, with p<0.05 considered statistically significant.
Findings: In a group of 50 children (mean age 43.48 ± 42.74 months), mean serum BNP levels increased significantly after intervention (from 130 to 1,475 pg/mL; p<0.001), while mean ejection fraction (EF) decreased from 68% to 62% (p<0.001). The post-intervention BNP elevation was significant in both moderate and severe shunt groups (p<0.001). Pre-intervention BNP was higher in patients with severe shunts (143.9 pg/mL) than in those with moderate shunts (p=0.02). After intervention, BNP remained markedly higher in the severe group (1,900.7 pg/mL; p<0.001).
Conclusion: Serum BNP measurement 48 hours after intervention provides a useful, though limited, indicator of hemodynamic status. Given its correlation with shunt severity, BNP may serve as a reliable adjunct biomarker for postoperative assessment and follow-up in pediatric CHD.
Keywords: Brain Natriuretic Peptide, Cardiac Catheterization, Child, Congenital Heart Defects, Corrective Cardiac Surgery
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