| Objective To investigate the levels of plasma NT-pro BNP,serum CA125 and the correlations among them. Then assess the values of the two biomarkers in the diagnosis of congestive heart failure and evaluation of cardiac function in children with congenital heart disease(CHD).Methods Seventy-four children with CHD were enrolled from the patients in the Cardiology Dept of Nanjing children’s hospital from July, 2011 to October, 2012.All of them were diagnosed by echocardiogram. There were 42 boys and 32 girls with their age ranged from 1.2 months to 36 months old. According to the modified ROSS Score, the patients were divided into two groups, congestive heart failure group(CHF)(n=34) and non-CHF group(n=40). The control group consisted of 22 children that included 12 boys and 10 girls. Plasma NT-pro BNP and serum CA125 levels were detected by an enzyme-linked immune sorbent assay(ELISA). The data were analyzed using the SPSS17.0 For Windows. All variable data were presented as mean with standard deviation(`x ± s),compared between groups using t test and ANOVA test. p<0.05 shows statistical significant difference. We also have done correlation analysis for all the variables.Results The comparisons of age and sex among three groups had no significant difference.The level of plasma NT-pro BNP in CHF group was 616.19±265.9pg/ml, significantly higher than that in non-CHF group(228.66±62.17pg/ml) and control group(122.05±55.47pg/ml), there were significant differences between them(p<0.01). We also found the difference between the non-CHF group and the control group. The level of serum CA125 in CHF group was 35.52±1.19U/ml, while the level of the non-CHF was(32.92±1.40 U/ml) and the level of the control group was(29.32±1.73 U/ml). Serum CA125 levels in three groups showed significant differences(p<0.01). In CHD group, we found that along with the aggravation of CHF, NT-pro BNP levels were higher. NT-pro BNP levels showed a positive correlation with the degree of heart failure. The level of serum CA125 were higher along with the aggravation of CHF. In CHD group, we found that the level of NT-pro BNP and serum CA125 both were positively correlated with the modified ROSS Score( r1=0.941, p1<0.001;r2=0.690, p2<0.01). The level of serum CA125 also positively correlated with the level of plasma NT-pro BNP in the CHF group(r=0.341, p<0.05). Using plasma NT-pro BNP content ≥287.35pg/ml, serum CA125 ≥34.05U/ml as cut-off values for diagnosing CHF respectively, the sensitivities were 97.1% and 94.1%, the specificities were 85.5% in the two biomarkers, and the areas under the ROC curves were 0.981 and 0.961, respectively. Using plasma NT-pro BNP content <287.35 pg/ml, serum CA125 content <34.05U/ml for excluding HF respectively, the negative predictive values were 96.7% and 93.5%.Conclusions 1.Plasma NT-pro BNP and serum CA125 levels were significantly higher in CHF group than in non-CHF and control group, both of them positively correlated with the cardiac dysfunction. Both of them could be used to evaluate cardiac function in the CHD patients. 2. Using plasma NT-pro BNP content ≥287.35pg/ml as cut-off value for diagnosing HF, the sensitivity is 97.1% and the specificity is 85.5%. At the same time, using serum CA125 ≥34.05U/ml as cut-off value for diagnosing HF, the sensitivity is 94.1% and the specificity is 85.5%. The results show that plasma NT-pro BNP levels maybe helpful in the early diagnosis of CHF in pediatrics 3. The level of serum CA125 positively correlated with the level of plasma NT-pro BNP in CHF group. It demostrates that serum level of CA125 maybe another biomarker in diagnosis of CHF after the discovery of NT-pro BNP. |
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