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N-terminal pro-B-type natriuretic peptide levels in children: comparison in cardiac and non-cardiac diseases

Published online by Cambridge University Press:  27 February 2020

Hyun Su Kim  and
Hee Joung Choi Open the ORCID record for Hee Joung Choi [Opens in a new window]
Hyun Su Kim
Affiliation:
Department of Pediatrics, Keimyung University School of Medicine, Daegu, South Korea
Hee Joung Choi*
Affiliation:
Department of Pediatrics, Keimyung University School of Medicine, Daegu, South Korea
*
Author for Correspondence: Hee Joung Choi, MD, Department of Pediatrics, Keimyung University School of Medicine, 1095 Dalgubeol-daero, Dalseo-gu, Daegu, 42601, South Korea. Tel: +82-53-258-7312. Fax: +82-53-258-7319. E-mail: joung756@dsmc.or.kr
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Abstract

Background:

N-terminal pro-B-type natriuretic peptide (NT-proBNP), a well-known marker of cardiac disease, may be elevated in acute infections and other non-cardiac diseases. The aim of this study was to evaluate NT-proBNP levels in cardiac and non-cardiac diseases and found out the patient’s clinical status that affects the NT-proBNP levels.

Methods:

NT-proBNP levels were measured in three groups of children: a cardiac disease group, an infectious disease group, and a non-cardiac, non-infectious disease group.

Result:

In total, 348 children were enrolled, including 134 patients (38.5%) with cardiac disease, 170 patients (48.9%) with infectious disease, and 44 patients (12.6%) with non-cardiac, non-infectious disease. The NT-proBNP level of the cardiac disease group (median: 548 pg/mL; range: 5–35,000 pg/mL) was significantly higher than that of the infectious disease group (median: 193 pg/mL; range: 10–35,000 pg/mL) and the non-cardiac, non-infectious disease group (median: 280 pg/mL; range: 6–35,000 pg/mL). Regarding clinical status, the NT-proBNP levels were significantly higher in patients who needed mechanical ventilation support, oxygen therapy, or inotropic medication or had a change in mental status than in other patients. However, the systemic inflammatory response syndrome and mortality were not related to the NT-proBNP level.

Conclusion:

Among heterogeneous group of children, NT-proBNP level can be a useful marker of cardiac disease. Furthermore, the NT-proBNP levels were related to patients’ clinical deteriorations, such as shock rather than the inflammatory status of patients.

Keywords

B-type natriuretic peptideheart diseaseacute illnessChildren
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 4 , April 2020 , pp. 500 - 504
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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References

Baughman, KL.B-type natriuretic peptide - a window to the heart. N Engl J Med 2002; 347: 158–159.CrossRefGoogle ScholarPubMed
Mair, J, Hammerer-Lercher, A, Puschendorf, B.The impact of cardiac natriuretic peptide determination on the diagnosis and management of heart failure. Clin. Chem Lab Med 2001; 39: 571–588.CrossRefGoogle ScholarPubMed
Maisel, AS, Krishnaswamy, P, Nowak, RM, et al.Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med 2002; 347: 161–167.CrossRefGoogle ScholarPubMed
Soldin, SJ, Soldin, OP, Boyajian, AJ, Taskier, MS.Pediatric brain natriuretic peptide and N-terminal pro-brain natriuretic peptide reference intervals. Clin Chim Acta 2006; 366: 304–308.CrossRefGoogle ScholarPubMed
Nir, Amiram, Lindinger, Angelika, Rauh, Manfred. Bar-Oz, Benjamin, NT-pro-B-type natriuretic peptide in infant and children: Reference values based on combined data from four studies, Pediatr Cardiol 2009; 30: 3–8.CrossRefGoogle ScholarPubMed
Oremus, M, McKelvie, R, Don-Wauchope, A, et al.A systematic review of BNP and NT-proBNP in the management of heart failure: overview and methods. Heart Fail Rev 2014; 19: 413–419.CrossRefGoogle ScholarPubMed
Clerico, A, Passino, C, Franzini, M, Emdin, M.Natriuretic peptides as biomarkers of cardiac endocrine function in heart failure: new challenges and perspectives. Future Cardiol 2016; 12: 573–584.CrossRefGoogle Scholar
Hammerer-Lercher, Angelika, Ralf, G.Utility of N-terminal Pro-B-Type Natriuretic peptide to differentiate cardiac diseases from noncardiac diseases in young pediatric patients. Clinical Chemistry 2006; 52: 1415–1419.CrossRefGoogle ScholarPubMed
Cantinotti, M, Walters, HL, Crocetti, M, Marotta, M, Murzi, B, Clerico, A.BNP in children with congenital cardiac disease: is there now sufficient evidence for its routine use? Cardiol Young 2015; 25: 424–437.CrossRefGoogle ScholarPubMed
Sugimoto, M, Manabe, H, Nakau, K, Furuya, A, Okushima, K, Fujiyasu, H, Kakuya, F, Goh, K, Fujieda, K, Kajino, H.The role of N-terminal pro-B-type natriuretic peptide in the diagnosis of congestive heart failure in children. - Correlation with the heart failure score and comparison with B-type natriuretic peptide -. Circ J 2010; 74: 998–1005.CrossRefGoogle Scholar
Jun, H, Ko, KO, Lim, JW, Yoon, JM, Lee, GM, Cheon, EJ.Age-adjusted plasma N-terminal pro-brain natriuretic peptide level in Kawasaki disease. Korean J Pediatr 2016; 59: 298–302.CrossRefGoogle ScholarPubMed
Cantinotti, M, Clerico, A.Brain natriuretic peptide and N-terminal pro-brain natriuretic peptide confirmed the prognostic accuracy in pediatric cardiac surgery: Time for their inclusion in prediction risk models? J Thorac Cardiovasc Surg 2017; 154: 641–643.CrossRefGoogle ScholarPubMed
Kawamura, T, Wago, M, Kawaguchi, H, Tahara, M, Yuge, M.Plastma natriuretic peptide concentrations in patients with Kawasaki disease. Pediatr Int 2000; 42: 241–248.CrossRefGoogle ScholarPubMed
Nevo, I, Erlichman, M, Algur, N, Nir, A.N-terminal pro B-type natriuretic peptide levels in infants and children with acute non-cardiac diseases. Isr Med Assoc J 2011; 13: 420–424.Google ScholarPubMed
Fried, I, Bar-Oz, B, Algur, N, et al.Comparison of N-terminal pro-B-type natriuretic peptide levels in critically ill children with sepsis versus acute left ventricular dysfunction. Pediatrics 2006;118:e1165–e1168.CrossRefGoogle ScholarPubMed
Hammerer-Lercher, A, Geiger, R, Mair, J, Url, C, et al.Utility of N-terminal pro-B-type natriuretic peptide to differentiate cardiac diseases from noncardiac diseases in young pediatric patients. Clin Chem 2006; 52: 1415–1419.10.1373/clinchem.2005.060608CrossRefGoogle ScholarPubMed
Rudiger, Alain, Gasser, Stefan. Comparable increase of b-type natriuretic peptide and amino terminal pro –B-type natriuretic peptide levels in patients with severe sepsis, septic shock, and acute heart failure. Crit Care Med 2006; 34: 2140–2144.CrossRefGoogle ScholarPubMed
Goldstein, B, Giroir, B, Randolph, A. International consensus conference on pediatric sepsis. International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med 2005; 6: 2–8.CrossRefGoogle Scholar
Levin, ER, Gardner, DG, Samson, WK.Natriuretic peptides. N Engl J Med 1998; 339: 321–328.Google ScholarPubMed
Clerico, A, Emdin, M.Diagnostic accuracy and prognostic relevance of the measurement of the cardiac natriuretic peptides: a review. Clin Chem 2004; 50: 33–50CrossRefGoogle ScholarPubMed
El Amrousy, D, Abd El-Hafez, M, Nashat, M, Hodeib, H.Cardiac injury after convulsive status epilepticus in children. Eur J Paediatr Neurol 2017; 21: 648–653.CrossRefGoogle ScholarPubMed
Alehan, F, Erol, I, Cemil, T, Bayraktar, N, Ogüs, E, Tokel, K.Elevated CK-MB mass and plasma brain-type natriuretic peptide concentrations following convulsive seizures in children and adolescents: possible evidence of subtle cardiac dysfunction. Epilepsia 2009; 50: 755–760.CrossRefGoogle ScholarPubMed