Abstract
INTRODUCTION: Atrial septal defect (ASD) increases pulmonary to systemic flow ratio (Q (p)/Q (s)) which is an important determinant factor for treatment. N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels are correlated with volume overloading of the heart. This study aims to explore the relationship between Q (p)/Q (s) and NT-proBNP levels in children with ASD. MATERIALS AND METHODS: Between January 2010 and December 2023, 464 patients under 20 years old with ASD who underwent cardiac catheterization and received NT-proBNP test were enrolled retrospectively. Baseline characteristics such as sex, body weight, and age were recorded. Q (p)/Q (s) was measured during standardized right heart catheterization according to Fick principle. RESULTS: A significant positive correlation existed between NT-proBNP and Q (p)/Q (s) (R = 0.507, P < 0.001), with an R (2) of 0.258. The linear regression model indicates that a one-unit (pg/ml) increase in NT-proBNP corresponded to a 0.003-unit increase in Q (p)/Q (s) (P < 0.001). Patients with a Q (p)/Q (s) ratio ≥ 2 had significantly higher NT-proBNP levels than those with a ratio <2 (P < 0.001). CONCLUSTION: This study, the largest cohort to date, reveals the correlation between non-invasive NT-proBNP level and invasive Q (p)/Q (s) measurement in children with ASD.