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N-terminal Pro-B-type Natriuretic Peptide and Ventricular Dysfunction in Children and Adolescents

Published online by Cambridge University Press:  23 October 2009

Armen Kocharian ,
Reza Shabanian ,
Mitra Rahimzadeh ,
Abdolrazagh Kiani ,
Ahmad Hosseini ,
Keyhan Sayadpour Zanjani ,
Giv Heidari-Bateni  and
Nasrollah Hosseini-Navid
Armen Kocharian
Affiliation:
Tehran University of Medical Sciences, Department of Pediatric Cardiology, Children’s Medical Center, Tehran, Iran
Reza Shabanian*
Affiliation:
Tehran University of Medical Sciences, Department of Pediatric Cardiology, Children’s Medical Center, Tehran, Iran
Mitra Rahimzadeh
Affiliation:
Tarbiat Modares University, Department of Biostatistics, Tehran, Iran
Abdolrazagh Kiani
Affiliation:
Tehran University of Medical Sciences, Department of Pediatric Cardiology, Children’s Medical Center, Tehran, Iran
Ahmad Hosseini
Affiliation:
Tehran University of Medical Sciences, Department of Pediatric Cardiology, Children’s Medical Center, Tehran, Iran
Keyhan Sayadpour Zanjani
Affiliation:
Tehran University of Medical Sciences, Department of Pediatric Cardiology, Children’s Medical Center, Tehran, Iran
Giv Heidari-Bateni
Affiliation:
Tehran University of Medical Sciences, Department of Pediatric Cardiology, Children’s Medical Center, Tehran, Iran
Nasrollah Hosseini-Navid
Affiliation:
Tehran University of Medical Sciences, Department of Pediatric Cardiology, Children’s Medical Center, Tehran, Iran
*
Correspondence to: Reza Shabanian MD, Children’s Medical Center, 62 Gharib Street, 14194, Tehran, Iran. Tel: +98-9122987428; Fax: +98-21-66930024. E-mail: rzshabanian@sina.tums.ac.ir, rshabanian@gmail.com
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Abstract

Our aim was further to clarify the diagnostic usefulness of N-terminal pro-B-type natriuretic peptide for detecting ventricular dysfunction in children, and its correlation with myocardial performance index and New York University Pediatric Heart Failure Index score. We also hypothesized that the level of this natriuretic peptide in the serum could predict the severity of diastolic abnormalities in children with cardiac failure. We enrolled 99 patients, aged from 3 months to 16 years, who had been referred for echocardiography to evaluate ventricular function. Echocardiographic evidence of left ventricular systolic and diastolic dysfunction was found in 20 and 42 patients, respectively. We classified these patients as having impaired relaxation, seen in 12 patients, pseudonormal patterns seen in 19 patients, and restrictive-like patterns of filling seen in 11 patients. The mean of the log-transformed values for N-terminal pro-B-type natriuretic peptide increased significantly according to the severity of diastolic dysfunction (p = 0.003, p = 0.022, p < 0.0001). A value of 178 pg/ml had a sensitivity of 88% and specificity of 81% for detecting abnormal diastolic function (p < 0.0001). Furthermore, the log-transformed values correlated with myocardial performance index (p < 0.0001) in a positive manner, and the levels increased significantly according to New York University Pediatric Heart Failure Index score, showing a linear correlation with a robust r value for regression (r = 0.89, p < 0.0001). Our findings suggest that higher levels of the peptide, having a good correlation with New York University Pediatric Heart Failure Index score and myocardial performance index, might be a suitable marker to rule out ventricular diastolic dysfunction in children.

Keywords

Biomarkermyocardial performance indexdiastolic dysfunctiondiagnostic test
Type
Original Articles
Information
Cardiology in the Young , Volume 19 , Issue 6 , December 2009 , pp. 580 - 588
Copyright
Copyright © Cambridge University Press 2009

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