| N-terminal Pro-B-type Natriuretic Peptide as a Predictive Risk Factor in Fontan Operation |
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Gi Young Jang, Jae Young Lee, Soo Jin Kim, Woo Sup Shim |
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Department of Pediatrics, Sejong Hospital, Bucheon, Korea |
| Fontan 수술시 위험 예측인자로서의 N-Terminal Pro-B-type Natriuretic Peptide의 유용성 |
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장기영, 이재영, 김수진, 심우섭 |
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부천세종병원 소아과 |
Correspondence:
Gi Young Jang, Email: jgynhg@dreamwiz.com
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| Abstract |
Purpose
: This study aimed to investigate the correlation between the plasma level of N-terminal pro-B-type natriuretic peptide(pro-BNP) and several known risk factors influencing outcomes after Fontan operations, and to assess whether pro-BNP levels can be used as predictive risk factors in Fontan operations.
Methods
: Plasma pro-BNP concentrations were measured in 35 patients with complex cardiac anomalies before catheterization. Cardiac catheterization was performed in all subjects. Mean right atrium pressure, mean pulmonary artery pressure(PAP), and ventricular end-diastolic pressure(EDP) were obtained. Cardiac output and pulmonary vascular resistance were calculated by Fick method.
Results
: Plasma pro-BNP levels exhibited statistically significant positive correlations with mean PAP(r=0.70, P<0.001), pulmonary vascular resistance(r=0.57, P<0.001), RVEDP(r=0.63, P<0.001), LVEDP(r=0.74, P<0.001), and cardiothoracic ratio(r=0.71, P<0.001). The area under the ROC curve using pro-BNP level to differentiate risk groups in Fontan operations was high : 0.868(95 percent CI, 0.712-1.023, P<0.01). The cutoff value of pro-BNP concentrations for the detection of risk groups in Fontan operations was determined to be 332.4 pg/mL(sensitivity 83.3 percent, specificity 82.7 percent).
Conclusion
: These data suggest that plasma pro-BNP levels may be used as a predictive risk factor in Fontan operations, and as a guide to determine the mode of therapy during follow-up after Fontan operations. |
| Key Words:
Fontan operation , Risk factor , B-type natriuretic peptide |
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