N-terminal pro-Brain Natriuretic Peptide as a Predictor of Reoperation in Children With Surgically Corrected Tetralogy of Fallot

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  • Hirono Keiichi
    Department of Pediatrics, Graduate School of Medicine, University of Toyama
  • Sekine Michikazu
    Department of Welfare Promotion and Epidemiology, Graduate School of Medicine, University of Toyama
  • Shiba Noriko
    Department of Clinical Pharmacy, Graduate School of Medicine, University of Toyama
  • Hayashi Shirou
    Department of Clinical Pharmacy, Graduate School of Medicine, University of Toyama
  • Nakaoka Hideyuki
    Department of Pediatrics, Graduate School of Medicine, University of Toyama
  • Ibuki Keijiro
    Department of Pediatrics, Graduate School of Medicine, University of Toyama
  • Saito Kazuyoshi
    Department of Pediatrics, Graduate School of Medicine, University of Toyama
  • Watanabe Kazuhiro
    Department of Pediatrics, Graduate School of Medicine, University of Toyama
  • Ozawa Sayaka
    Department of Pediatrics, Graduate School of Medicine, University of Toyama
  • Higuma Tomonori
    First Department of Surgery, Graduate School of Medicine, University of Toyama
  • Yoshimura Naoki
    First Department of Surgery, Graduate School of Medicine, University of Toyama
  • Kitajima Isao
    Department of Clinical Pharmacy, Graduate School of Medicine, University of Toyama
  • Ichida Fukiko
    Department of Pediatrics, Graduate School of Medicine, University of Toyama

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Background: Most patients with surgically corrected tetralogy of Fallot (TOF) are faced with multiple residua and sequelae such as pulmonary regurgitation (PR), resulting in reoperation for pulmonary valve replacement (PVR). Plasma brain natriuretic peptide (BNP) level and serum N-terminal pro-BNP (NT-pro-BNP) level are useful as diagnostic objective markers of chronic heart failure (CHF). The aim of the study was to examine whether these markers have predictive ability for reoperation in children with surgically corrected TOF. Methods and Results: Fifty-eight patients (38 male, 20 female) aged 1–18 years (median, 7 years) were enrolled. Serum NT-pro-BNP in TOF patients was significantly higher than in age-matched hospital controls without CHF (359.5±449.7pg/ml vs. 86.1±45.1pg/ml, respectively; P<0.0001). BNP and NT-pro-BNP had a better correlation with CHF index, RVEDP, and LVEDV in TOF groups. Children with surgically corrected TOF who had indication for PVR had higher BNP and NT-pro-BNP and more severe PR than those without indication for PVR. On multivariate logistic regression analysis, NT-pro-BNP was the strongest predictor for reoperation in patients with surgically corrected TOF. Area under the curve of NT-pro-BNP for reoperation was 0.950 (P<0.001) with a sensitivity of 88.9% and specificity of 91.8%. Conclusions: NT-pro-BNP is a good biomarker for monitoring CHF, and is a good predictor of PVR in children with surgically repaired TOF.  (Circ J 2014; 78: 693–700)<br>

収録刊行物

  • Circulation Journal

    Circulation Journal 78 (3), 693-700, 2014

    一般社団法人 日本循環器学会

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