Abstract
Background: The N-terminal pro-brain natriuretic peptide (NTproBNP) has a longer serum half-life than the brain natriuretic peptide (BNP), and it is reported to be advantageous in the accurate detection of congestive heart failure (CHF) in adults. However, it has not been sufficiently examined in children. Therefore, we investigated which of the 2 peptides is more beneficial and identified their cut-off levels at the CHF grades in children. Methods: Plasma BNP and serum NTproBNP levels were determined in 252 healthy children (median age, 3.5 years) and in 142 children with congenital heart disease (median age, 2.6 years). CHF severity was assessed by using the modified Ross score to classify the severity into 4 grades (I–IV). The BNP and NTproBNP levels were analyzed and compared with the CHF grade. Results: Both BNP and NTproBNP levels increased significantly with the CHF grades (Fig. 1 ). The change in the NTproBNP level was more remarkable in each CHF grade than in BNP. Furthermore, at CHF grades of II or higher, the area under the receiver operating characteristic curve was larger with NTproBNP than with BNP (Fig. 2 ). The cut-off levels of BNP and NTproBNP were 47.3 and 333.4 pg/mL, respectively, in CHF grade II and higher; 101.4 and 2415.5 pg/mL, respectively, in CHF grade III and higher; and 320.0 and 3617.0 pg/mL, respectively, in CHF grade IV. Conclusions: Our study clearly demonstrated that blood levels of BNP and NTproBNP reflected the severity of CHF in the children. Of these, NTproBNP showed better specificity and sensitivity for the evaluation of CHF severity in children. Therefore, we concluded that NTproBNP is beneficial as a biomarker for assessing CHF in children. This research has received full or partial funding support from the American Heart Association, AHA National Center. Fig. 1 Fig. 2
Published Version
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