Prognostic Value of Serum B-Type Natriuretic Peptide in Early Mortality and Morbidity of Children with Congenital Heart Disease after Open Heart Surgery

Abstract

Background: Brain type natriuretic peptide (BNP) is a cardiac hormone that is secreted mainly by the ventricles in response to volume expansion and pressure load. It can predict post-operative complications after heart surgery in adults. We sought to investigate the prognostic value of BNP in children after heart surgery.

Methods: We measured the BNP serum levels in 96 children with congenital heart diseases before, immediately after, and 12 hours after open heart surgery. We studied the ability of the post-operative BNP serum level variations to predict mortality and morbidity in children.

Results: In total, 96 patients, comprising 40 (41.7%) females and 56 (58.3%) males with a mean age of 4.1 years (range: 1 month to 17 years), with various congenital heart diseases were studied. The rise in the serum BNP level 12 hours post surgery was directly related to mortality before discharge from hospital (P value=0.004), congestive heart failure after surgery (P value<0.001) , patients' cyanosis (P value=0.045), duration of ICU stay (r=0.342, P value=0.004), and post-operative need for inotropic drugs (P value<0.001).

Conclusion: The rise in the BNP serum level 12 hours after heart surgery is a good marker for predicting mortality, morbidity, and early diagnosis of heart failure in children.