Document Detail

Effectiveness of serial increases in amino-terminal pro-B-type natriuretic Peptide levels to indicate the need for mechanical circulatory support in children with acute decompensated heart failure.
MedLine Citation:
PMID:  21295174     Owner:  NLM     Status:  In-Data-Review    
We sought to determine prospectively whether serial assessment of the natriuretic peptide prohormone, amino-terminal pro-B-type natriuretic peptide (NT-pro-BNP), correlated with clinical severity and outcomes in children hospitalized for acute decompensated heart failure (ADHF). Patients (>1 month of age) admitted from 2005 to 2007 with ADHF requiring intravenous vasoactive/diuretic therapy for ADHF were eligible. Serum NT-pro-BNP levels were obtained within 24 hours of admission and at prespecified intervals, and clinical caregivers were blinded to these levels. End points included hospital discharge, death or cardiac transplantation, and care escalation including the need for mechanical circulatory support (MCS) was noted. Twenty-four patients were enrolled: 22 survived to hospital discharge and 2 died. Ten required MCS (of which 6 underwent cardiac transplantation). Two patients underwent transplantation without MCS. For the entire cohort, NT-pro-BNP levels peaked at days 2 to 3 after admission, with a subsequent gradual decrease until discharge. However, for those who did require MCS, NT-pro-BNP failed to decrease consistently until after MCS initiation. At discharge, NT-pro-BNP levels were significantly decreased from admission levels but remained well above normal for all patients. Single-point NT-pro-BNP levels on admission did not correlate with independently assessed clinical scores of heart failure severity or predict the need for MCS in this cohort. In conclusion, serial NT-pro-BNP levels demonstrated an incremental trend after 48 hours in patients who went on to require MCS but decreased in all other patients and may therefore assist the decision to initiate or avoid MCS after admission for pediatric ADHF.
Derek T H Wong; Kristen George; Judith Wilson; Cedric Manlhiot; Brian W McCrindle; Khosrow Adeli; Paul F Kantor
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  107     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  573-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Department of Pediatrics, Division of Pediatric Cardiology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
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