Relationship of Pro-BNP Levels with Cardiovascular Events in Pediatric Cardiac and Non-cardiac Diseases

Öz

Aim We aimed to determine the relationship of Pro-BNP levels, with the diagnosis, clinical, and laboratory parameters in children. In addition, the predictive power of the Pro-BNP levels in determining the cardiovascular events was evaluated. Patients and methods: This study comprised 829 patients whose levels of Pro-BNP were measured. The data were obtained retrospectively from the hospital records. The relationship of the Pro-BNP level of the patients with the clinical, laboratory, and echocardiographic data was determined. The predictive power of the Pro-BNP and Troponin T levels in determining the development of cardiovascular events was evaluated. Results: Cardiovascular events developed in 143 patients during the follow-up period. The Pro-BNP levels were observed to be significantly higher (p< 0.001) in the group in which patients developed cardiovascular events. The Pro-BNP levels demonstrated a positive correlation with both Troponin T levels and procalcitonin levels and a strong negative correlation with the age, height, and weight of the patients. The most important predictive factors for determining the development of cardiovascular events were the presence of tachypnea, increased Pro-BNP levels, increased left ventricular end-diastolic diameter, and increased tricuspid regurgitation velocity. Conclusion: The most important determinants of a cardiovascular event, as revealed in the present study, are the presence of tachypnea, Pro-BNP levels, TR velocity, and the LVEDD z-score of patients. Moreover, the Pro-BNP levels and Troponin levels demonstrate a strong positive correlation. Randomized prospective studies are warranted to improve the efficacy of using Pro-BNP in differentiating cardiac and non-cardiac diseases in children.

Anahtar Kelimeler

• Brain natriuretic peptide
• congenital heart disease
• sepsis
• Troponin T

Pediyatrik kardiyak ve nonkardiyak hastalıklarda pro- BNP düzeyi ile kardiyovasküler olayların ilişkisi

Öz

Amaç: Bu çalışmada amacımız Pro- BNP düzeyi ile hastaların tanıları, klinik ve laboratuvar bulguları arasındaki ilişkiyi değerlendirmektir. Ayrıca pro-BNP düzeyinin kardiyovasküler olay belirlemedeki öngörü düzeyini değerlendirmeyi amaçladık. Hastalar ve metod: Bu çalışmada, Pro-BNP düzeyi bakılmış olan 829 hastanın verileri elektronik dosya kayıtlarından retrospektif olarak elde edildi. Pro-BNP düzeyi ile hastaların klinik, laboratuvar ve ekokardiyografik verileri rasındaki ilişki değerlendirildi. Ayrıca Pro- BNP ve troponin T düzeylerinin kardiyovasküler olayları belirleyiciliği değerlendirildi. Sonuçlar: Takip süresi oyunca 143 hastada kardiyovasküler olay gelişti. Pro-BNP seviyesi bu hasta grubunda anlamlı yüksekti (p< 0,001). Pro- BNP düzeyi ile troponin T, prokalsitonin düzeyi ile pozitif, yaş, boy ve vücut ağırlığı ile güçlü negatif korelasyon mevcuttu. Kardiyovasküler olay belirlemede en güçlü prediktörler takipne, artmış Pro- BNP, artmış triküspit kapak velositesi ve artmış sol ventrikül end-diyastolik çapı idi. Sonuç: Bu çalışmada kardiyovasküler olay belirlemede en güçlü belirleyiciler takipne, Pro-BNP düzeyi, triküspit yetersizlik velositesi ve sol ventrikül end-diyastolik çapı Z skoru idi. Ayrıca pro-BNP ve Troponin T düzeyleri arasında güçlü pozitif korelasyon mevcuttu. Çocuklarda kardiyak ve nonkardiyak hastalıkların ayırımında pro-BNP düzeyi belirleyiciliği düşük bulunmuş olup, randomize prospektif kontrollü çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• Beyin natriüretrik peptid
• konjenital kalp hastalığı
• sepsis
• troponin T

Kaynakça

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