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N-terminal pro-brain natriuretic peptide level as a screening tool for cardiac involvement in paediatric diseases of extracardiac origin

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Abstract

Background

Serum concentrations of N-terminal natriuretic pro-brain natriuretic peptide (NT-proBNP) correlate well with the severity of cardiac disease in children and adults. There are also paediatric illnesses of extracardiac origin that may cause deterioration of the cardiac function in some patients (pts). A high NP level can signify a concomitant cardiac involvement in respiratory distress, or secondary to a systemic disease.

Objective

To assess the potential of NT-proBNP as a screening tool for cardiac involvement in paediatric diseases of extracardiac origin.

Methods

A literature search was performed in PubMed for the relevant studies with the subject brain natriuretic peptide (BNP) and NT-proBNP from 1995 to 2010 with stress on characteristics of the natriuretic peptides, paediatric reference values and systemic paediatric diseases with potential influence on the myocardial performance. The main focus has been NT-proBNP being the most stable NP and correlating well with BNP.

Results

Most studies agree that a high NT-proBNP level indicates cardiac dysfunction in different systemic diseases such as thalassemia and cystic fibrosis or in pts after chemotherapy. In special clinical scenarios as sepsis or respiratory distress, NT-proBNP helps to narrow down the differential diagnosis or can be used for risk stratification.

Conclusion

NT-proBNP can serve as a screening tool in various primarily non-cardiac paediatric diseases. Together with the clinical picture, a high level suggests further assessment by a paediatric cardiologist.

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Abbreviations

NT-proBNP:

N-terminal natriuretic pro-brain natriuretic peptide

BNP:

Brain natriuretic peptide

NP:

Natriuretic peptide

ECHO:

Echocardiogram

eGFR:

Effective glomerulation filtration rate

KD:

Kawasaki disease

PDA:

Patent ductus arteriosus

PHT:

Pulmonary hypertension

CF:

Cystic fibrosis

APSGN:

Acute post streptococcal glomerulonephritis

DMD:

Duchenne muscular dystrophy

IVIG:

Intravenous immunoglobulin

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Authors and Affiliations

  1. Department of Paediatrics, Children’s Hospital, London Health Science Centre, University of Western Ontario, 800 Commissioners Road East, London, ON, N6A 5W9, Canada

    Eva Welisch, Kambiz Norozi & Ralf Rauch

  2. Department of Paediatric Cardiology, Medical School of Hannover, Hannover, Germany

    Kambiz Norozi

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  1. Eva Welisch
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  2. Kambiz Norozi
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Correspondence to Eva Welisch.

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Welisch, E., Norozi, K. & Rauch, R. N-terminal pro-brain natriuretic peptide level as a screening tool for cardiac involvement in paediatric diseases of extracardiac origin. Clin Res Cardiol 100, 723–730 (2011). https://doi.org/10.1007/s00392-011-0317-0

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