Relationship between Plasma Brain Natriuretic Peptide,Endothelin-1 and Left Ventricular End Diastolic Vo-lume Index,Left Ventricular Ejection Fraction in Children with Heart Failure

Objective To explore the relationship between plasma brain natriuretic peptide(BNP),endothelin-1(ET-1)and left ventricular end diastolic volume index(LVEDVI),left ventricular ejection fraction(LVEF)in children with heart failure and their clinical significance.Methods Forty-one children with heart disease were divided into Ⅰ,Ⅱ,Ⅲ and Ⅳ groups according to New York Heart Assciation(NYHA)heart functional class.Plasma BNP and ET-1 concentration were determined before and after treatment.All patients had echocardiographic study,including measurement of LVEDVI and LVEF.The relationship between plasma BNP,ET-1 and LVEDVI,LVEF were studied.Twenty healthy children were included in healthy control group,plasma BNP and ET-1 concentration were also determined.Results 1.Plasma BNP and ET-1 concentration in children with heart failure were significantly higher than those of healthy control group,and increased with the degree of heart failure.2.Plasma BNP and ET-1 concentration in children with heart failure were positively correlated with NYHA heart functional class(r=0.70,0.61 Pa0.01)and LVEDVI(r=0.70,0.58 Pa0.01),and were negatively correlated with LVEF(r=-0.62,-0.60 Pa0.01),among them the correlation of BNP was the best.Using plasma BNP concentration ≥65 ng/L,LVEF45% as cut-point for diagnosing heart failure,the sensitivity was 97.06% and the specificity was 100%.3.In children with heart failure,plasma BNP and ET-1 concentration and LVEDVI post-treatment were significantly lower than those of pretherapy(Pa0.05),and LVEF were significantly increased(Pa0.01).4.The level of plasma BNP and ET-1 concentration had nothing to do with the cause of heart fai-lure.Conclusions The level of plasma ET-1 concentration is correlated with clinical manifestations of heart failure,while the level of plasma BNP has high sensitivity and specificity for diagnosis of heart failure.The combination of plasma BNP and LVEF is more sensitive and accurate in evaluating cardiac function.J Appl Clin Pediatr,2009,24(1):41-43