OBJECTIVETo study the plasma natriuretic peptide (BNP) level in children with pulmonary artery hypertension (PAH) secondary to congenital heart disease (CHD) and its correlation with left ventricular diastolic function.

METHODSDoppler echocardiography was performed on 95 CHD children with PAH (PAH group) and on 42 CHD without PAH (control group). The plasma BNP level was measured using radioimmunity assay.

RESULTSDoppler echocardiography showed that the left ventricular end-diastolic diameter (LVDd), the right ventricular diameter end-diastolic (RVDd), and the pulmonary artery diameter (PAd) increased significantly in the PAH group compared with those in the control group (p<0.05). The PAH group had higher velocity of tricuspid regurgitation (VTR) and higher pulmonary artery systolic pressure (PASP) than the control group (p<0.05). The PAH group also had higher mitral A peak velocity (AV), higher mitral A peak velocity integral (AVI), higher E peak velocity intgral (EVI), and higher ratio of mitral AV to mitral E peak velocity (EV) and AVI/EVI ratio as well as prolonged left ventricular volumetric relaxation time than the control group. PASP was positively correlated with the AV/EV ratio (p<0.05). The plasma BNP level in the PAH group increased significantly compared with that in the control group. In the PAH group, the plasma BNP level was positively correlated with the pulmonary artery pressure and the ratio of AV/EV.

CONCLUSIONSThe left ventricular diastolic function is positively correlated with the plasma BNP level in children with PAH secondary to CHD. BNP may play an important role in the generation and development of left ventricular diastolic dysfunction induced by PAH.