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Increased plasma levels of natriuretic peptide type B and A in children with congenital heart defects with left compared with right ventricular volume overload or pressure overload
Author(s) -
Holmgren Daniel,
Westerlind Andreas,
Lundberg PerArne,
Wåhlander Håkan
Publication year - 2005
Publication title -
clinical physiology and functional imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.608
H-Index - 67
eISSN - 1475-097X
pISSN - 1475-0961
DOI - 10.1111/j.1475-097x.2005.00622.x
Subject(s) - medicine , volume overload , pressure overload , ventricle , cardiology , atrial natriuretic peptide , natriuretic peptide , hemodynamics , brain natriuretic peptide , doppler echocardiography , heart disease , ventricular pressure , heart failure , blood pressure , diastole , cardiac hypertrophy
Summary Aim: Natriuretic peptide levels B (BNP) and A (ANP) have been described in children with congenital heart defects (CHD) with pressure and volume overload. However, the impact of ventricular morphology per se on natriuretic peptide levels has not been reported. The aim of the present study was to evaluate plasma BNP and ANP in children with CHD with left or right ventricular volume or pressure overload. Methods and results: Plasma BNP and ANP were analysed in 61 children, median age 3·1 (0·3–16·2) years. Haemodynamic load was evaluated by echo‐Doppler and/or catheterization measurements and classified as: pressure overload of the right ( RV pressure ) or left ( LV pressure ) ventricle, or volume overload of the right ( RV volume ) or left ( LV volume ) ventricle, of a sufficient degree to indicate surgery/catheter intervention. Twenty‐three children, with a median age of 1·1 (0·1–8·3) years, without heart disease, served as controls for the natriuretic peptide measurements. Children in the LV volume group had significantly higher BNP and ANP values, 55·4 ng l −1 (10·7–352) and 164 (31·8–346), than children in the RV volume , 15·6 (0·0–105·1) and 57·2 (11·3–234·1), LV pressure , 6·8 (0·7–170) and 40·8 (12·6–210), and RV pressure , 18·0 (5·0–29·1) and 69·3 (8·7–182), groups respectively ( P <0·0001). The values in the LV pressure group were close to the values in the Control group, 4·7 (0·0–17·7) and 32·9 (11·7–212·1), respectively ( P = 0·051 and P = 0·378, respectively). Conclusions: Plasma concentrations of BNP and ANP were higher in children with CHD with left ventricular volume overload compared with right ventricular volume overload or pressure overload.