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KMID : 0857220040080020362
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Journal of the Korean Pediatric Cardiology Society
2004 Volume.8 No. 2 p.362 ~ p.371
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Plasma Concentrations of N-terminal Pro-Brain Natriuretic Peptide in Pediatric Heart Disease and Adult Congenital Heart Disease
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Lim Kyoung-Ah
Kim Sung-Hye
Huh June
Kang I-Seok
Lee Heung-Jae
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Abstract
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Purpose: The plasma concentrations of brain natriuretic peptide(BNP) and amino- terminal fragment of the BNP prohormone(NT-proBNP) are well known to be elevated in adult patients with chronic heart failure. The aim of this study was to evaluate the efficacy of NT-proBNP in various pediatric heart diseases and in adult congenital heart diseases.
Methods: Twenty-two children with cardiac diseases and 16 adult patients with congenital heart diseases were enrolled. Plasma NT-proBNP concentrations were determined and compared with other parameters which represent patient’s hemodynamic conditions.
Results: Plasma NT-proBNP concentrations were elevated in patients with left ventricle dysfunction or right ventricle overload. In these patients, NT-proBNP concentrations tended to be high in patients with higher NYHA functional class. In patients with surgically repaired Tetralogy of Fallot, after Fontan operation, and before coarctoplasty, NT-proBNP concentrations were significantly high. There were 5 patients had over 10,000 pg/mL of NT-proBNP level. Among them, 3 patients were died during the hospital course of treatment and 2 were needed emergency surgical intervention.
Conclusion: Plasma NT-proBNP is a marker of left and right ventricular impairment in pediatric heart disease and adult congenital heart disease. It also related to other parameters of severity of the disease. Very high concentration of NT-proBNP(>10,000 pg/ mL) was associated with poor prognosis. Plasma NT-proBNP may provide quantitative follow up of ventricular dysfunction in these patients.
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KEYWORD
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Brain natriuretic peptide, Congenital heart disease, Adult congenital heart disease
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