NT-pro Brain Natriuretic Peptide in Infants with Single Ventricle Heart Disease in the CHAMP® Multi-site Registry

The role of NT-pro Brain Natriuretic Peptide (NT-proBNP) and BNP in single ventricle (SV) patients during the interstage period is not well understood. We sought to describe NT-proBNP and BNP in a large group of SV infants and to determine if there is an association between pre-discharge NT-proBNP and interstage outcomes (unplanned hospitalizations [UPH]/interventions). We identified SV infants at 11 Cardiac High Acuity Monitoring Program (CHAMP) centers from 2014 to 2021 using the CHAMP multisite registry. Patients with NT-proBNP/BNP drawn prior to neonatal discharge were included, with the last value identified. Demographics, clinical characteristics, and events were collected. zlog transformation was used to convert NT-proBNP values to a normal distribution. Two-sided t-tests (α = 0.05) were used to evaluate average differences in zlog transformed NT-proBNP between patients with an UPH/intervention versus those with neither. 268 patients (male = 178, 66.4%) were included. The most common diagnosis was hypoplastic left heart syndrome, (N = 105, 39.2%). Median NT-proBNP (N = 136) and BNP (N = 132) were 5295 (IQR 2905-8590) and 299 (IQR 158-543), respectively, with median zlog-NT-proBNP 2.87 (IQR 2.24, 3.55). UPH/interventions occurred in 142 patients (53%). There was no significant difference in zlog-NT-proBNP in patients with UPH/interventions versus neither (p-value = 0.872). We described BNP, NT-proBNP, and zlog-NT-proBNP in SV infants at interstage discharge. Further investigation is needed to understand whether NT-proBNP/BNP and zlog-NT-proBNP can prognosticate outcomes after initial SV/interstage discharge.