室间隔缺损患儿封堵术前后血浆N末端B型利钠肽原和左心室Tei指数变化的意义

Objective To explore the implication of the dynamic changes of plasma N-terminal proB-type natriuretic peptide (NT-proBNP) level and Tei index of left ventricle (LV) in children with ventricular septal defect(VSD) treated by transcatheter closure. Methods Sixty children with VSD treated by transcatheter closure with VSD occluder (Group VSD) and 30 healthy children (Group C) were included in this study. The plasma concentration of NT-proBNP, Tei index of LV and left ventricle ejection fraction (LVEF) were measured in Group C and at before, 5th minute, 4th hour, 1st month, 3rd month and 6th month after VSD closure in Group VSD. Results ( 1 ) The concentration of plasma NT-proBNP was significantly increased in children with VSD before transcatheter closure compared with Group C (229.45 ±57.75 ) ng/L vs. (99. 21 ± 46. 86) ng/L,P ＜ 0. 01], significantly increased at 5th minute and 24th hour after transcatheter closure( 356.27 ± 96. 78 ) ng/L and ( 356. 38 ± 91.95 ) ng/L vs. ( 229. 45 ± 57.75 ) ng/L, all P ＜0. 01], and significantly decreased at 1st month, 3rd months and 6th months after transcatheter closure ( 131.33 ± 34. 79 ) ng/L, (96. 56 ± 31.55 ) ng/L and ( 93. 39 ± 29. 46 ) ng/L vs. ( 229. 45 ± 57.75 ) ng/L,P＜0.05 or P＜0. 01]. (2) The Tei indexes of LV in Group VSD before transcatheter closure were significantly higher than in Group C (0. 45 ± 0. 05 vs. 0. 33 ± 0. 08, P ＜ 0. 01 ) and Tei index was significantly increased at 24th hour, 1 st month after transcatheter closure (P ＜ 0. 01 ) while significantly decreased at 3rd and 6th month compared with those before transcatheter closure (0. 34 ±0. 07 and 0. 34 ±±0. 06 vs. 0. 45 ±0. 05 ,all P ＜0. 01 ). (3) There is a positive correlation between the changes of the plasma concentration of NT-proBNP and the change of Tei index of LV before and after transcatheter closure (r = 0. 653, P ＜ 0. 05).Conclusion Tei index of LV and NT-proBNP can monitor cardiac function changes in children with VSD before and after transcatheter closure.

Implication of N-terminal pro-B-type natriuretic peptide and Tei index of left ventricle changes in children with ventricular septal defect treated by tanscatheter interventional therapy