The Change And Clinical Significance Of Plasma Brain In Natriuretic Peptide In Children With Cardiovascular Disease

Objective:To describe the plasma levels of brain natriuretic peptide (active brain natriuretic peptide,active-BNP,referred to as BNP) in children with cardiovascular disease,and further to research the diagnostic significance on children’s cardiovascular disease.Methods:The study comprised 1030 subjects with assayed the plasma leves of BNP who were admitted patients of Children’s Hospital of Chongqing Medical University from March 2013 to September 2014.All subjects were divided into two groups——the group with cardiovascular diseasre and without cardiovascular diseasre.According to the clinical heart failure children in cardiovascular diseasre were divided into heart failure group and non-heart failure group,at the same time,were also divided into cardiac function grade I group, heart function grade Ⅱ group, cardiac function grade Ⅲ group, cardiac function grade IV group.Even more according to the results of left ventricular ejection fraction(referred to LVEF) in echocardiography the children were divided into the normal group and abnormal group.What’s more,the plasma levels of BNP were assayed using enzyme immunoassay (referred to as ELASA method).To analyse the relationship in all groups and compare the plasma BNP levels,heart chamber size,heart function etc.Result:Collected a total of 1030 cases,725 of them were diagnosed as cardiovascular disease(male 401,female 324)included congenital heart disease,myocarditis,dilated cardiomyopathy,arrhythmia,Kawasaki disease,endocardium elastic fiber hyperplasiaand so on,the rest were not(male 189,female 119).Among the group with cardiovascular disease,137 children had been diagnosed with heart failure,others were not The 305 cases were non-cardiovascular disease mainly included pneumonia, upper respiratory tract infection and so on.Compared to the children without cardiovascular disease (1.0086±0.0225 pg/mL),the plasma levels of LogBNP in the group without heart failure (1.4920±0.0245 pg/mL) were significantly increased (P<0.05) and the phenomenon was also remarkable obvious in the group with heart failure,however there is statistically significant difference between the group without heart failure C1.3092±0.0204 pg/mL) and the group with heart failure(2.2763±0.0607pg/mL).The plasma levels of LogBNP were significantly positive correlated with heart function (r=0.657, P<0.05),and negative correlated with LVEF (r=-0.412, P<0.05) nevertheless LVEF in normal and abnormal group the plasma levels of LogBNP were respectively 2.5900±0.0927 pg/mL,1.3476±0.0232pg/mL,the difference between the two groups was significant(P<0.05).Further more the area under the ROC(receiver operating characteristic) curve which reflected LogBNP and LVEF was respectively 0.872 and 0.285.The sensitivity and specificity in diagnose of heart failure was respectively 81.4% and 81.5%,when the plasma levels of BNP were 42.51 pg/mL.Compare the children without cardiovascular disease(1.0086±0.0225 pg/mL),the plasma levels of LogBNP are higher than the children with Kawasaki disease (referred to as KD) (1.3157±0.0422 pg/mL),significant difference was found(P<0.05)Conclusion:The plasma levels of BNP can be used as a biology reference index for clinical diagnosis of the children with cardiovascular disease, even for early diagnosis of heart failure.