The Clinical Value Of N-Terminal Pro-brain Natriuretic Peptide On Cardiac Function Of Left To Right Shunt Congenital Heart Disease In Infants

Objective By discussing the changes of plasma N-terminal pro brain natriuretic prptide(NT-pro BNP)levels in infants with left to right shunt congenital heart disease children(CHD)with heart failure(HF),and evaluating the clinical cardiac function in children with HF,analyzing the correlation between plasma NT-pro BNP and modified Ross score,and drawing receiver operating characteristic curve(ROC),to find a rapid detecting method for the diagnosis of left to right shunt CHD with HF in infants,to find out the diagnostic cutoff value of plasma NT-Pro BNP in children with HF of different cardiac function classification,to quantify HF classification,and provide a more objective,simple and practical criteria for the diagnosis of left to right shunt CHD with HF.Methods In the experimental group,there were 54 patients with left to right shunt CHD whose were hospitalized in Department of Cardiology,Pediatric Clinical College of Anhui Medical University,all of those were diagnosed by echocardiography in January 2015-June 2016,Those diseases including atrial septal defects,ventricular septal defect and patent ductus arteriosus.The patients Aged 1 month to 1 year old,with an average age of 144±93days,there were 32 males and 22 females.There were 12 children with Slight respiratory infections in the control group.a total of 12 cases,there were 8 males and 4females,aged 1 month to 1 year old,with an average age of 212 ± 127 days.The experimental group is divided according to modified Ross score,among of them,13 cases without HF,15 cases mild HF,13 cases moderate HF,13 cases severe HF.The peripheral venous blood samples of both experimental groups and control groups were drawn after hospitalization,The detector is US(Roche)Cobas h 232 rapid heart failure diagnostic apparatus,and the Roche CARDIAC test strip is the corresponding test strip.Test results can be measured in 8~12 minutes.Results The levels of plasma NT-pro BNP in children with CHD was positively related to the modified Ross score,and the NT-pro BNP levels increased with the modified Ross score(r = 0.85,P < 0.05).Compared with the control group,the plasma NT-pro BNP levels in children with left to right shunt CHD were significantly higher,between of them were significant difference(P < 0.05).And there was a significant difference in plasma NT-pro BNP between the different HF grades(F = 59.68,P < 0.05),and the NT-pro BNP levels in different HF grades exist significant differences before and after treatment(P <0.05).By drawing the ROC curve,it is concluded that the cutoff value of cardiac dysfunction in children with left to right shunt CHD is 286.50 pg/m L,the cutoff value of diagnose mild HF is 635.50 pg/m L,the cutoff value of diagnosis moderate HF is 1680.5 pg/m L,diagnosis severe HF is 3863.00 pg/m L.Conclusion Plasma NT-pro BNP can be sensitively reflect the severity of HF,is positively correlation with modified Ross score.According to our study,obtain that NT-pro BNP > 286.50 pg/m L,it can be used as a diagnostic cutoff value for the cardiac dysfunction in infants with left to right shunt CHD,the cutoff value of diagnose mild HF,moderate HF,and severe HF respectively were 635.50 pg/m L,1680.50 pg/m L and 3863.00 pg/m L.There were significant difference between different groups before and after treatment,which can be used as an important monitoring method to evaluate the effect of treatment in chidren whose combined with HF.