Comparison Of Pro-BNP Levels And Myocardial Performance Index Before And After Iron Treatment In Children With Congenital Cyanotic Heart Disease With Iron Deficiency Anemia

Öz

Introduction: Our aim was to compare NT-proBNP levels and cardiac functions after iron therapy in children with congenital cyanotic heart disease who had iron deficiency anemia.

Materials and Methods: We included 40 children with pre-established cyanotic congenital heart disease and accompanying iron deficiency anemia, between the age of 6 months and 17 years, who were admitted to the outpatient clinic of Çukurova University Faculty of Medicine, Department of Pediatric Cardiology between September 2015 and March 2016. We recorded demographic data and performed following investigations: complete blood count, peripheral blood smear, reticulocyte count, measurement of serum iron levels, total iron-binding capacity, ferritin levels, transferrin saturation and NT-proBNP levels, and echocardiographic examination.

Results: There was a statistically significant increase in following laboratory parameters after iron therapy: hemoglobin, hematocrit, MCV, MCHC, serum iron and ferritin, transferrin saturation and oxygen saturation. During the follow-up period, RDW and NT-proBNP levels were significantly decreased. In left ventricular tissue doppler; there was a significant difference in MPI measurements before and after treatment. There was no significant difference in other echocardiography findings.

Conclusion: Iron therapy has improved cardiac functions in children with cyanotic congenital heart disease, and NT-proBNP levels can be used to evaluate the efficacy of treatment in the follow-up period.

Anahtar Kelimeler

• Cyanotic congenital heart disease,iron deficiency anemia,NT-proBNP,echocardiography

Demir Eksikliği Anemisi Olan Doğumsal Siyanotik Kalp Hastalıklı Çocuklarda Demir Tedavisi Öncesi ve Sonrası Pro-BNP Düzeyleri ve Miyokardiyal Performans İndekslerinin Karşılaştırılması

Öz

Amaç: Demir eksikliği anemisi olan doğumsal siyanotik kalp hastalıklı çocuklarda demir tedavisi sonrası NT-proBNP düzeyleri ve kardiyak fonksiyonların karşılaştırılmasıdır.

Gereç ve Yöntem: Eylül 2015 - Mart 2016 tarihleri arasında Çukurova Üniversitesi Tıp Fakültesi Çocuk Kardiyoloji Bilim Dalı polikliniğine başvuran, siyanotik doğuştan kalp hastalığı tanılı, demir eksikliği anemisi saptanan altı ay ile 17 yaşları arasındaki 40 çocuk hasta çalışmaya alınmıştır. Çeşitli sebeplerden dolayı 26 hasta ile sonuçlar değerlendirilmiştir. Hastaların ilk geliş ve üçüncü ay kontrollerinde; demografik verileri, tam kan sayımı, periferik yayma, retikülosit, serum demir, total demir bağlama kapasitesi, ferritin düzeyleri, transferrin satürasyonlarıu, NT-proBNP düzeyleri ve Eko bulguları değerlendirilmiştir.

Bulgular: Hastaların demir tedavisi öncesi ve sonrası laboratuvar değerlerinde; hemoglobin, hematokrit, MCV, MCHC, demir, ferritin, transferin saturasyonu, oksijen saturasyonu değerleri tedavi sonrası istatistiksel olarak anlamlı derece artmıştır. RDW ve NT-proBNP düzeyleri yüksekliği kontrol sonuçlarında anlamlı olarak düşmüştür. Sol ventrikül doku dopplerinde; MPİ ölçümlerinde tedavi öncesi ve sonrasında anlamlı farklılık saptanmıştır. Diğer EKO bulgularında anlamlı farklılık saptanmamıştır.

Sonuç: Demir tedavisi sonrası siyanotik doğuştan kalp hastalıklı çocuklarda kardiyak fonksiyonlarda iyileşme saptanmış olup NT-proBNP takipte, tedavinin değerlendirilmesinde kullanılabilir.

Anahtar Kelimeler

• Siyanotik doğuştan kalp hastalığı,demir eksikliği anemisi,NT-proBNP,ekokardiyografi

Kaynakça

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