OS 24-06 HIGH B-TYPE NATRIURETIC PEPTIDE IS ASSOCIATED WITH LEFT VENTRICULAR HYPERTROPHY AND HEART FAILURE IN CHILDREN WITH HYPERTENSION ON PERITONEAL DIALYSIS

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Abstract

Objective:

To evaluate the relationship between B-type natriuretic peptide (BNP) and cardiac parameters on echocardiography.

Design and Method:

Echocardiography was checked at 6 months ∼ 1 year interval in children with end-stage renal disease on peritoneal dialysis, which was more frequently done in patients with hypertension or any heart problems. We reviewed blood pressure (BP) and echocardiographic findings of those children (since February 2005). Data were presented as mean ± standard deviation (median, minimum ∼ maximum). Linear regression analysis was used to see the correlation of BNP with BP. Nonlinear regression analysis power model was used to evaluate the association between serum BNP level and cardiac parameters on echocardiography.

Results:

Fifty nine patients were enrolled in this study and total of 171 echocardiographic findings were evaluated in association with serum BNP level. Systolic BP (SBP) was 125.3 ± 21.9 (125.0, 56 ∼ 208) mmHg and diastolic BP (DBP) 50.5 ± 16.5 (80.0, 25 ∼ 141) mmHg. Serum BNP level was 938.0 ± 4030.4 (63, 2 ∼ 40897) pg/mL. On echocardiography, left ventricular mass index (LVMI) was 67.3 ± 37.2 (59.8, 12.4 ∼ 332.5) g/m2.7, ejection fraction (EF) 60.6 ± 15.5 (65.4, 13.3 ∼ 90.2) % and fractional shortening (FS) 33.8 ± 11.5 (35.5, 6.0 ∼ 99.3) %. BNP was significantly correlated with SBP (adjusted R square = 0.038, p = 0.007), DBP (adjusted R square = 0.024, p = 0.026), LVMI (adjusted R square = 0.123, p < 0.001), EF (adjusted R square = 0.094, p < 0.001) and FS (adjusted R square = 0.069, p < 0.001). Other parameters also showed significant correlation with serum BNP level such as internal diameter of left atrium, aorta, right ventricle in diastolic phase and internal diameter of left ventricle in systolic phase etc.

Conclusions:

Routine measurement of serum BNP is recommended in children on peritoneal dialysis to evaluate the risk of left ventricular hypertrophy and heart failure.

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