Clinical Research Of Plasma BNP And MMP-3 Levels In Pediatric Heart Failure

Objective: The study sought to evaluate the change of plasma brain natriretic peptide and matrix metalloproteinase-3 in pediatric heart failure, and the relationship with heart function and index of echography, and the diagnostic and prognostic value in HF. It is further to determine whether plasma levels of brain natriuretic peptide (BNP) could differentiate between heart failure and lung disease among infants with acute respiratory distress.Methods: 40 patients with heart failure including 23 patients secondary to congential heart disease and 17 patients secondary to primary pneumonia were involved in our research. We classed the heart function according to the NYHA class and the ROSS class. The control groups were 15 patients who were in hospital waiting for selective operation and 15 patients with acute respiratory distress because of pneumonia. All objects were evaluated with blood,dung,urine,rout,liver,renal function, myocardium creatase, electrocardiogram,roentgenogram,echocardiogram,BNP,MMP-3. plasma BNP,MMP-3 were detected with enzyme linked immunosorbent assay. Patients with HF were followed up in three months after post-discharge. The measurement data was represented by x±S. Plasma BNP and MMP-3 levels in each class and inter class compared by one-way ANOVA and independent-sample T test. We analysised the relationship between plasma BNP and cardiac functional grading,LVEF by the stepwise regression and linear correlation analysis test.Results: Patients with HF had higher plasma BNP than patients without HF(426.73±249.73pg/ml VS 34.73±3.49pg/ml). The difference had significance(P<0.01). Patients with HF had higher plasma MMP-3 than patients without HF(124.33±62.03 ng/ml VS 47.53±25.7 ng/ml P<0.01). Plasma BNP and MMP-3 rised with deteriorate heart function. Plasma BNP were significantly realated with heart function(r=0.93 P<0.01), left ventricular ejection fraction(r=-0.73 P<0.01), left ventricular fractional shortening(r=-0.61 P<0.01). Plasma MMP-3 were significantly realated with heart function(r=0.75 P<0.01), left ventricular ejection fraction(r=0.58 P < 0.01), left ventricular fractional shortening(r=-0.65 P<0.01). Plasma BNP may be helpful in diagnosis of HF, area under the curve of ROC was 0.90, 95%CI: 0.80-0.99, P<0.01. Plasma BNP predicted the cardiovascular event in three months, area under the curve of ROC was 0.786, 95%CI:0.566-1.006 P<0.05.Conclusitions: Plasma BNP and MMP-3 levels rised in HF and were significantly realated with heart function and frequently used index of echography.plasma. BNP may be helpful in the diagnosis of HF in pediatrics. Plasma levels of brain natriuretic peptide (BNP) could differentiate between heart failure and lung disease among infants with acute respiratory distress. Plasma BNP can predict the cardiovascular events in three months. Plasma MMP-3 did not have the contribution.