BB-type Natriuretic Peptide (BNP) is a cardiac neurohormone specifically secreted by the cardiac ventricles in response to volume expansion, pressure overload, and resultant increased wall tension. This study was designed to explore whether it was possible to evaluate the perioperative setting of ventricular septum defect (VSD) and tetralogy of Fallot (TOF) by measuring BNP levels, cytokines and inflammatory markers.
A prospective study conducted between June 2004 and February 2005 included 16 consecutive patients who had been surgically corrected, including TOF (n=7; 44%), and VSD (n=9; 56%). Detailed clinical parameters were reviewed. The blood level of BNP, lactase, inflammatory marker (while blood cells, WBC; high-sensitive C-reaction protein, hs-CRP), and cytokines (interleukine-6, IL-6; -8, IL-8; and tumor necrotizing factor-α;, TNF-α;) had been evaluated before and the day after operation.
The patient population was comprised of 4 (25%) women and 12 (75%) men. The mean age of patients’ participants was 18 months, with an age range of 6 to 59 months. BNP levels showed lower in VSD compared with TOF perioperation. In the TOF patients, BNP levels rose from 63 +/- 80 pg/ml before operation to 592 +/- 279 pg/ml 24 hours after operation (P<0.000); in VSD changed from 12.8 +/- 7 pg/ml to 140 +/- 72 pg/ml perioperation (P<0.000). In VSD and TOF patients, BNP levels correlated significantly with Qp/Qs, and peak RVP/LVP. BNP levels were well-correlated with the severity of the disease. The levels of lactase, hc-CRP, IL-6, IL-8 and TNF-;α were elevated significantly after postoperation in VSD patients (P<0.000); but not WBC, IL-8 or TNF-α; in TOF.
We conclude that BNP is a useful diagnostic tool in the identification of the condition and residual VSD for the patients with VSD and TOF. Levels of IL-6, and hs-CRP also increased significantly after surgery.
BNP is a useful diagnostic tool for perioperative evaluation.
Pao-Hsien Chu, None.