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Diagnostic accuracy and clinical relevance of brain natriuretic peptide assay in pediatric patients with congenital heart diseases.
J Cardiovasc Med (Hagerstown). 2009 Sep; 10(9):706-13.JC

Abstract

BACKGROUND

The clinical usefulness of B-type natriuretic peptide (BNP) assay in congenital heart diseases is still controversial. We evaluated the diagnostic accuracy and clinical relevance of this assay in different cardiovascular hemodynamic conditions in pediatric patients with congenital heart diseases.

MATERIALS AND METHODS

BNP was measured in 173 healthy individuals and in 382 pediatric patients with congenital heart diseases. We identified five subgroups of hemodynamic conditions: left ventricular volume overload, right ventricular volume overload, left ventricular pressure overload, right ventricular pressure overload, and biventricular volume overload.

RESULTS

BNP was higher (P<0.0001) in patients (median 49.0 ng/l, range 0.45-14363 ng/l) than in the reference population (median 6.1 ng/l, range 1.0-29.7 ng/l). BNP assay showed a good diagnostic accuracy in discriminating between healthy individuals and patients (area under the receiver operating characteristic curve 0.95, SE 0.009). Lower BNP values were found in right ventricular pressure overload than in left ventricular pressure overload, left ventricular volume overload, or biventricular volume overload. In the left ventricular volume overload subgroup, BNP significantly correlated with peak systolic gradients (rho=0.622, P<0.001) and left ventricular dilatation (rho=0.35, P=0.03). In the right ventricular volume overload subgroup, BNP correlated with right ventricular pressure (rho=0.622, P<0.001) and right ventricular dilatation (rho=0.377, P=0.0077). Moreover, in cyanotic defects, BNP showed a significant correlation with O2 saturation (rho=0.204 P=0.0128).

CONCLUSION

BNP assay showed a good diagnostic accuracy in discriminating between healthy individuals and patients. Congenital heart disease with left ventricular pressure overload and biventricular volume overload has higher BNP values than that with right ventricular pressure overload.

Authors+Show Affiliations

Pediatric Cardiology and Pediatric Cardiac Surgery Unit, Molecular Cardiology and Genetics Laboratory, G Monasterio Foundation and Institute of Clinical Physiology-National Research Council, Heart Hospital, Massa, Italy. cantinotti@ifc.cnr.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19444132

Citation

Cantinotti, Massimiliano, et al. "Diagnostic Accuracy and Clinical Relevance of Brain Natriuretic Peptide Assay in Pediatric Patients With Congenital Heart Diseases." Journal of Cardiovascular Medicine (Hagerstown, Md.), vol. 10, no. 9, 2009, pp. 706-13.
Cantinotti M, Vittorini S, Storti S, et al. Diagnostic accuracy and clinical relevance of brain natriuretic peptide assay in pediatric patients with congenital heart diseases. J Cardiovasc Med (Hagerstown). 2009;10(9):706-13.
Cantinotti, M., Vittorini, S., Storti, S., Prontera, C., Murzi, M., De Lucia, V., Recla, S., Assanta, N., Giusti, S., Murzi, B., Bottone, U., & Clerico, A. (2009). Diagnostic accuracy and clinical relevance of brain natriuretic peptide assay in pediatric patients with congenital heart diseases. Journal of Cardiovascular Medicine (Hagerstown, Md.), 10(9), 706-13. https://doi.org/10.2459/JCM.0b013e32832c15fb
Cantinotti M, et al. Diagnostic Accuracy and Clinical Relevance of Brain Natriuretic Peptide Assay in Pediatric Patients With Congenital Heart Diseases. J Cardiovasc Med (Hagerstown). 2009;10(9):706-13. PubMed PMID: 19444132.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnostic accuracy and clinical relevance of brain natriuretic peptide assay in pediatric patients with congenital heart diseases. AU - Cantinotti,Massimiliano, AU - Vittorini,Simona, AU - Storti,Simona, AU - Prontera,Concetta, AU - Murzi,Michele, AU - De Lucia,Vittoria, AU - Recla,Sabine, AU - Assanta,Nadia, AU - Giusti,Sandra, AU - Murzi,Bruno, AU - Bottone,Ugo, AU - Clerico,Aldo, PY - 2009/5/16/entrez PY - 2009/5/16/pubmed PY - 2009/9/9/medline SP - 706 EP - 13 JF - Journal of cardiovascular medicine (Hagerstown, Md.) JO - J Cardiovasc Med (Hagerstown) VL - 10 IS - 9 N2 - BACKGROUND: The clinical usefulness of B-type natriuretic peptide (BNP) assay in congenital heart diseases is still controversial. We evaluated the diagnostic accuracy and clinical relevance of this assay in different cardiovascular hemodynamic conditions in pediatric patients with congenital heart diseases. MATERIALS AND METHODS: BNP was measured in 173 healthy individuals and in 382 pediatric patients with congenital heart diseases. We identified five subgroups of hemodynamic conditions: left ventricular volume overload, right ventricular volume overload, left ventricular pressure overload, right ventricular pressure overload, and biventricular volume overload. RESULTS: BNP was higher (P<0.0001) in patients (median 49.0 ng/l, range 0.45-14363 ng/l) than in the reference population (median 6.1 ng/l, range 1.0-29.7 ng/l). BNP assay showed a good diagnostic accuracy in discriminating between healthy individuals and patients (area under the receiver operating characteristic curve 0.95, SE 0.009). Lower BNP values were found in right ventricular pressure overload than in left ventricular pressure overload, left ventricular volume overload, or biventricular volume overload. In the left ventricular volume overload subgroup, BNP significantly correlated with peak systolic gradients (rho=0.622, P<0.001) and left ventricular dilatation (rho=0.35, P=0.03). In the right ventricular volume overload subgroup, BNP correlated with right ventricular pressure (rho=0.622, P<0.001) and right ventricular dilatation (rho=0.377, P=0.0077). Moreover, in cyanotic defects, BNP showed a significant correlation with O2 saturation (rho=0.204 P=0.0128). CONCLUSION: BNP assay showed a good diagnostic accuracy in discriminating between healthy individuals and patients. Congenital heart disease with left ventricular pressure overload and biventricular volume overload has higher BNP values than that with right ventricular pressure overload. SN - 1558-2027 UR - https://www.unboundmedicine.com/medline/citation/19444132/Diagnostic_accuracy_and_clinical_relevance_of_brain_natriuretic_peptide_assay_in_pediatric_patients_with_congenital_heart_diseases_ L2 - http://dx.doi.org/10.2459/JCM.0b013e32832c15fb DB - PRIME DP - Unbound Medicine ER -