N-terminal pro-brain natriuretic peptide levels in patients with anomalous left coronary artery from pulmonary artery
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(2020) 15:15
RESEARCH ARTICLE
Open Access
N-terminal pro-brain natriuretic peptide levels in patients with anomalous left coronary artery from pulmonary artery Ling Yunfei, Fan Qiang, Wang Yue and Qian Yongjun*
Abstract Introduction: N-terminal pro-brain natriuretic peptide (NT-pro-BNP) is used as an important biomarker for heart failure in children and adults. Previous researches have shown the value of NT-pro-BNP in various congenital heart defects (CHD). However, the level of NT-pro-BNP in patients with anomalous left coronary artery from the pulmonary artery (ALCAPA) has not been determined. Materials and methods: Plasma NT-pro-BNP was measured in 23 patients diagnosed with ALCAPA before operation. Echocardiogram was also recorded for each patient. Results: Patients with NT-pro-BNP above 300 pg/mL showed a statistically significant decrease in LVEF (p < 0.0001) and in age (p < 0.0001) compared to patients with NT-pro-BNP below 300 pg/mL. Age (r = 0.399, p = 0.012) and LVEF (r = 0.403, p = 0.011) showed a statistically significant correlation with NT-pro-BNP in linear regression when NT-pro-BNP more than 300 pg/mL. A negative correlation was shown between NT-pro-BNP and LVEF (r = 0.570, p < 0.0001) in all the patients. No significant correlation was observed between mitral regurgitation (MR) grade and NTpro-BNP in a Spearman correlation test (r = 0.383; P = 0.071). Conclusions: In patients with ALCAPA, NT-pro-BNP levels showed a negative correlation with age and LVEF when NT-pro-BNP above 300 pg/mL and no correlation with age and LVEF when NT-pro-BNP under 300 pg/ml. Further studies are needed to determine whether there is a correlation between MR grade and NT-pro-BNP levels. Keywords: N-terminal pro-brain natriuretic peptide, Anomalous left coronary artery from the pulmonary artery, Mitral regurgitation
Introduction The main site of brain natriuretic peptide (BNP) synthesis and release is the cardiac ventricle, which releases BNP in response to stretch due to increased blood volume or pressure. Previous work has established the role of NTpro-BNP in the diagnosis and treatment of heart failure (HF) [1, 2]. NT-pro-BNP has also been indicated as a strong independent prognostic factor in patients with various congenital heart diseases (CHD) [3–6]. However, the presentation of natriuretic peptides in ALCAPA has rarely been reported.
* Correspondence: [email protected] Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Guoxuexiang 37th, 610041 Chengdu, Sichuan, People’s Republic of China
ALCAPA is a rare but potentially fatal CHD which is associated with adult sudden death and early infant mortality. Currently the most effective treatment is surgical coronary artery rebuilding while the prognosis is poor if left untreated [7]. ALCAPA is conventionally divided into two types, which present in infants or adults. In infants, little or no collateral coronary circulation develops and there is early onset of symptoms when pulmonary artery (PA) pressure falls after closure of the duct
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