Document Detail


The value of serum N-terminal pro-brain natriuretic peptide levels in the differential diagnosis and follow-up of congestive cardiac failure and respiratory distress due to pulmonary aetiologies in infants and children.
MedLine Citation:
PMID:  20529396     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We aimed to determine whether N-terminal pro-brain natriuretic peptide can differentiate between cardiac and pulmonary aetiologies of dyspnoea, if N-terminal pro-brain natriuretic peptide can be used for evaluating the effect of treatment in cardiac failure, and for predicting severe pulmonary diseases that are complicated by cardiac failure.
METHODS: In all, 76 children with dyspnoea were enrolled; 41 of them suffered cardiac failure - 25 caused by cardiac disease, 16 caused by pulmonary disease - and 35 had dyspnoea due to pulmonary disease. The control group consisted of 32 children. We calculated Ross scores, analysed N-terminal pro-brain natriuretic peptide levels, and evaluated left ventricular systolic functions by echocardiography.
RESULTS: N-terminal pro-brain natriuretic peptide levels were significantly higher in children with cardiac failure than in those with pulmonary disease and in controls (medians 7321, 241, 87.71 picograms per millilitre, respectively), were higher in children with cardiac failure due to pulmonary disease than in those with only pulmonary disease (medians 2728, 241 picograms per millilitre, respectively), and were higher in children who died from cardiac failure than in survivors (p < 0.05). After treatment of cardiac failure, N-terminal pro-brain natriuretic peptide levels decreased significantly (p < 0.001). The cut-off level of N-terminal pro-brain natriuretic peptide for differentiating cardiac failure from pulmonary disease was 726.8 picograms per millilitre, sensitivity 100%, specificity 94.3%.
CONCLUSIONS: N-terminal pro-brain natriuretic peptide levels can differentiate dyspnoea due to cardiac failure from pulmonary diseases. It can also be used to monitor the effects of treatment of cardiac failure and to estimate the prognosis, as well as to predict pulmonary diseases that are complicated with cardiac failure.
Authors:
Melike Sezgin Evim; Birsen Ucar; Zübeyir Kilic; Omer Colak
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-06-08
Journal Detail:
Title:  Cardiology in the young     Volume:  20     ISSN:  1467-1107     ISO Abbreviation:  Cardiol Young     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-02     Completed Date:  2011-01-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9200019     Medline TA:  Cardiol Young     Country:  England    
Other Details:
Languages:  eng     Pagination:  495-504     Citation Subset:  IM    
Affiliation:
Department of Pediatric Cardiology, Eskisehir Osmangazi University, Turkey. melikevim@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Biological Markers / blood
Child
Child, Preschool
Diagnosis, Differential
Echocardiography
Female
Follow-Up Studies
Heart Failure / blood,  complications,  diagnosis*
Humans
Immunoassay
Infant
Infant, Newborn
Lung Diseases / blood,  complications,  diagnosis*
Male
Natriuretic Peptide, Brain / blood*
Peptide Fragments / blood*
Prognosis
Protein Precursors
Respiratory Insufficiency / blood,  diagnosis*,  etiology
Retrospective Studies
Severity of Illness Index
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Peptide Fragments; 0/Protein Precursors; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain

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