Document Detail

B-type natriuretic peptide in paediatric patients with congenital heart disease.
MedLine Citation:
PMID:  16467354     Owner:  NLM     Status:  MEDLINE    
AIMS: To examine the diagnostic value of B-type natriuretic peptide (BNP) plasma concentration in congenital heart disease. METHODS AND RESULTS: BNP was measured in 288 consecutive patients (mean age 6.0 +/- 6.4 years) with left-to-right shunt, left or right heart obstruction, tetralogy of Fallot, functionally univentricular heart, or impaired left ventricular function and compared with age- and gender-specific normal values, and to haemodynamic and echocardiographic data. BNP increased with decreasing left ventricular shortening fraction (r = -0.80; P < 0.001). In patients with left-to-right shunt, BNP was increased (mean SDS +1.64; P < 0.001) and positively correlated (P < 0.001) to shunt volume (r = 0.66), systolic right ventricular pressure (r = 0.69), mean pressure of the pulmonary artery (r = 0.66), and pulmonary resistance (r = 0.59). There was no correlation between BNP and invasive pressure gradient or extent of ventricular hypertrophy in patients with left or right heart obstruction. In patients with tetralogy of Fallot, BNP was not significantly increased. Patients with functionally univentricular heart had elevated BNP plasma levels (mean SDS +1.39; P < 0.001) without decrease after volume unloading by cavopulmonary connection. CONCLUSION: In children with congenital heart defects, plasma BNP correlates closely to ventricular function. BNP plasma levels do not reflect directly the extent of ventricular pressure or volume work, but mirror the impairment of the loaded ventricles. Normal BNP cannot exclude pathology, but reflects a compensated status of the heart.
Andreas Koch; Stefan Zink; Helmut Singer
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Publication Detail:
Type:  Journal Article     Date:  2006-02-08
Journal Detail:
Title:  European heart journal     Volume:  27     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-03-16     Completed Date:  2006-07-31     Revised Date:  2006-11-21    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  861-6     Citation Subset:  IM    
Paediatric Cardiology, Department of Paediatrics and Adolescent Medicine, University of Erlangen-Nürnberg, Germany.
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MeSH Terms
Blood Pressure / physiology
Case-Control Studies
Child, Preschool
Heart Defects, Congenital / diagnosis*,  physiopathology
Infant, Newborn
Natriuretic Peptide, Brain / metabolism*
Pulmonary Artery / physiology
Vascular Resistance / physiology
Ventricular Dysfunction, Left / diagnosis,  physiopathology
Reg. No./Substance:
114471-18-0/Natriuretic Peptide, Brain
Comment In:
Nat Clin Pract Cardiovasc Med. 2006 Jul;3(7):362-3   [PMID:  16810169 ]

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