Predictive value of preoperative N-terminal pro-brain natriuretic peptide for postoperative early outcomes in infants with aortic coarctation
- VernacularTitle:N 端前体脑钠肽对主动脉缩窄术后早期结果的预测价值
- Author:
MU Hongwei
1
,
2
;
ZHU Zhongqun
1
,
2
Author Information
1. Department of Cardiothoracic Surgery, Heart Center, Shanghai Children&rsquo
2. s Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, 200127, P.R.China
- Publication Type:Journal Article
- Keywords:
Aortic coarctation;
N-terminal-pro-brain natriuretic peptide;
biomarker
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2020;27(02):156-163
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the predictive value of N-terminal-pro-brain natriuretic peptide (NT-ProBNP) for postoperative early outcomes in infants with aortic coarctation (CoA). Methods A retrospective study was conducted in 344 children with CoA admitted to our hospital from September 2014 to October 2017, including 206 males (59.9%) and 138 females (40.1%), with an average age of 0.2-60.0 (7.1±10.6) months. The levels of NT-proBNP, clinical characteristics, imaging data and early follow-up results were collected and analyzed. Results Compared with the normal NT-proBNP group, there were statistical differences in age, the proportion of RACHS-1≥3, the proportion of preoperative pneumonia and dysplastic aortic arch, preoperative cardiac function, left ventricular wall thickness, left ventricular dilatation, hospital stay, ICU duration, ventilator duration, duration of vasoactive drugs use, delayed chest closure, nasal continuous positive airway pressure (nCPAP), postoperative cardiac insufficiency in the abnormal NT-proBNP group (P<0.05). According to multivariate logistic regression analysis, NT-proBNP level (>3 000 pg/mL) was an independent risk factor for prolonged ICU duration [OR=3.17, 95%CI (1.61, 6.23)], prolonged ventilator duration [OR=5.84, 95%CI (2.86, 11.95)], prolonged use of vasoactive drugs [OR=2.22, 95%CI (1.22, 4.02)], postoperative cardiac insufficiency [OR=3.10, 95%CI (1.64, 5.85)]; NT-proBNP level (> 5 000 pg/mL) was an independent risk factor for delayed chest closure [OR=3.55, 95%CI (1.48, 8.50)]. Conclusion NT-proBNP level in children with CoA can be affected by many factors, including age, complexity of congenital heart disease, preoperative cardiac insufficiency, et al. The level of NT-proBNP has predictive value for postoperative early outcomes.
