Association of preoperative NT-proBNP with postoperative inflammatory factors levels among children of unrestricted left-to-right shunts congenital heart disease

Abstract

Abstract This study aimed to evaluate preoperative N-terminal pro-B-type natriuretic peptide (NT-proBNP) in children with pulmonary arterial hypertension (PAH) secondary to unrestricted left-to-right shunts congenital heart disease (CHD) and sought to investigate the correlation between NT-proBNP and inflammatory factor levels following cardiac surgery with cardiopulmonary bypass (CPB). A retrospective observational study was conducted involving 59 infants or children under 2 years old. Echocardiography was employed to measure tricuspid annular peak systolic velocity (TRV). The plasma of preoperative NT-proBNP and perioperative inflammatory cytokines, including IL-6, IL-8, IL-10, IL-1β, and TNF-α were measured. Additionally, postoperative ventilation time, length of Intensive care unit (ICU) and ward stay were recorded. Longer postoperative ventilation time, ICU stay and ward stay exhibited in PAH-CHD patients, and elevated preoperative NT-proBNP levels were associated with preoperative pulmonary artery systolic pressure (PASP). Moreover, there was a significant increase in postoperative inflammatory cytokines, including IL-6, IL-8 and IL-10 (p＜0.05). Importantly, preoperative NT-proBNP was identified as being associated with inflammatory cytokines levels after surgery. Conclusion: Preoperative NT-proBNP level was associated with PASP before surgery in children with unrestricted left-to-right shunts PAH-CHD, and elevated preoperative NT-proBNP levels were associated with significantly increased inflammatory factors after CPB, suggesting a potential correlation with early poor postoperative clinical outcomes.