Application Of BNP And HS-CTnI In Cadiac Function Evaluation Of Infants With Left-Right Shunt Congenital Heart Disease Complicated With Severe Pneumonia

Objective: To explore the clinical value of plasma Brain Natriuretic Peptide(BNP)and Hypersensitive Cardiac Troponin I(HS-CTnI)in evaluating cardiac function in infants with left-to-right shunt Congenital Heart Disease(CHD)complicated with severe pneumonia.Methods: Clinical data of infants with left-to-right shunt CHD complicated with severe pneumonia diagnosed in the children's hospital of chongqing medical university from June 2015 to June 2019 were retrospectively collected and analyzed.Cardiac function was assessed within 24 hours after admission,and echocardiography was examined within 48 hours.Another infants with left-to-right shunt CHD without pneumonia and heart failure(HF)were selected as the control group.To compare the difference of plasma BNP and HS-CTnI levels among different groups,to analyze the correlation between the two and cardiac ultrasound indexes such as the LVEF and E/A ratio,and to explore their application value in diagnosing heart failure in infants.Results: 1)The plasma BNP,HS-CTnI level in HF group was significantly higher than that in non-HF group and control group(P<0.01),and there was no significant difference in plasma BNP,HS-CTnI level between non-HF group and control group(P>0.05),but the abnormal rate in non-HF group was significantly higher than that in control group(P<0.05).2)In the HF group,BNP,HS-CTnI was negatively correlated with LVEF(r =-0.290,P = 0.022,r =-0.277,P = 0.030),negatively correlated with E/ A ratio(r =-0.346,P= 0.011,r =-0.315,P = 0.021).3)The cut-off value of plasma BNP in the diagnosis of HF was 115.13 pg/ml,the sensitivity was 0.806,and the specificity was 0.826.The cut-off value of plasma HS-CTnI in the diagnosis of HF alone was 0.054 ? g/L,the sensitivity was 0.790,and the specificity was 0.764.4)The logistic regression analysis of plasma BNP combined with HS-CTnI showed that the accuracy of combined diagnosis of HF was improved,the sensitivity was 0.784,and the specificity was 0.883.Conclusion: The determination of plasma BNP,HS-CTnI can provide timely,effective and simple biological reference indexes for the diagnosis of HF in infants with left-to-right shunt CHD complicated with severe pneumonia,and are closely related to cardiac function.The combined application of the two indexes could significantly improve the diagnostic accuracy of HF in infants with left-to-right shunt CHD complicated with severe pneumonia,which was beneficial to the early clinical diagnosis and accurate identification of HF,in order to make timely referrals and make treatment plans,so as to avoid the delay and aggravation of the disease.