N-terminal pro-Brain Natriuretic Peptide as a Predictor of Reoperation in Children With Surgically Corrected Tetralogy of Fallot
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概要
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Background: Most patients with surgically corrected tetralogy of Fallot (TOF) are faced with multiple residua and sequelae such as pulmonary regurgitation (PR), resulting in reoperation for pulmonary valve replacement (PVR). Plasma brain natriuretic peptide (BNP) level and serum N-terminal pro-BNP (NT-pro-BNP) level are useful as diagnostic objective markers of chronic heart failure (CHF). The aim of the study was to examine whether these markers have predictive ability for reoperation in children with surgically corrected TOF. Methods and Results: Fifty-eight patients (38 male, 20 female) aged 1–18 years (median, 7 years) were enrolled. Serum NT-pro-BNP in TOF patients was significantly higher than in age-matched hospital controls without CHF (359.5±449.7pg/ml vs. 86.1±45.1pg/ml, respectively; P<0.0001). BNP and NT-pro-BNP had a better correlation with CHF index, RVEDP, and LVEDV in TOF groups. Children with surgically corrected TOF who had indication for PVR had higher BNP and NT-pro-BNP and more severe PR than those without indication for PVR. On multivariate logistic regression analysis, NT-pro-BNP was the strongest predictor for reoperation in patients with surgically corrected TOF. Area under the curve of NT-pro-BNP for reoperation was 0.950 (P<0.001) with a sensitivity of 88.9% and specificity of 91.8%. Conclusions: NT-pro-BNP is a good biomarker for monitoring CHF, and is a good predictor of PVR in children with surgically repaired TOF.
著者
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Kitajima Isao
Department Of Clinical And Laboratory Medicine Faculty Of Medicine Toyama Medical And Pharmaceutical
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Hirono Keiichi
Department Of Department Of Pediatrics Graduate School Of Medicine University Of Toyama
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Ichida Fukiko
Department Of Department Of Pediatrics Graduate School Of Medicine University Of Toyama
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Yoshimura Naoki
First Department Of Surgery University Of Toyama Graduate School Of Medicine
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Saito Kazuyoshi
Department Of Agricultural Chemistry Kyoto University
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Watanabe Kazuhiro
Department Of Anesthesiology And Critical Care Medicine University Of Tsukuba
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Sekine Michikazu
Department Of Welfare Promotion And Epidemiology Graduate School Of Medicine And Pharmaceutical Scie
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Nakaoka Hideyuki
Department Of Pediatrics Graduate School Of Medicine And Pharmaceutical Sciences University Of Toyama
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HIGUMA Tomonori
First Department of Surgery, University of Toyama, Graduate School of Medicine
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Nakaoka Hideyuki
Department of Pediatrics, Graduate School of Medicine, University of Toyama
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Shiba Noriko
Department of Clinical Pharmacy, Graduate School of Medicine, University of Toyama
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Hayashi Shirou
Department of Clinical Pharmacy, Graduate School of Medicine, University of Toyama
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Ibuki Keijiro
Department of Pediatrics, Graduate School of Medicine, University of Toyama
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Ozawa Sayaka
Department of Pediatrics, Graduate School of Medicine, University of Toyama
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Higuma Tomonori
First Department of Surgery, Graduate School of Medicine, University of Toyama
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Saito Kazuyoshi
Department of Pediatrics, Graduate School of Medicine, University of Toyama
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Sekine Michikazu
Department of Welfare Promotion and Epidemiology, Graduate School of Medicine, University of Toyama
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Yoshimura Naoki
First Department of Surgery, Graduate School of Medicine, University of Toyama
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