Accuracy of plasma B-type natriuretic peptide to diagnose significant cardiovascular disease in children: the Better Not Pout Children! Study.

Full Abstract

OBJECTIVES: The purpose of this study was to assess the ability of plasma B-type natriuretic peptide (BNP) to diagnose significant cardiovascular disease (CVD) in the pediatric population. BACKGROUND: BNP has been shown to be reliable in detecting ventricular dysfunction and heart failure in adults. Timely and accurate identification of significant pediatric heart disease is important but challenging. A simple blood test could aid the front-line physician in this task. METHODS: Subjects without a history of heart disease with findings possibly attributable to significant CVD in the acute care setting requiring a cardiology consult were enrolled. Clinicians were blinded to the BNP result, and confirmation of disease was made by cardiology consultation. RESULTS: Subjects were divided into a neonatal (n = 42, 0 to 7 days) and older age group (n = 58, >7 days to 19 years). CVD was present in 74% of neonates and 53% of the older age group. In neonates with disease, median BNP was 526 pg/ml versus 96 pg/ml (p < 0.001) for those without disease. In older children with disease, median BNP was 122 pg/ml versus 22 pg/ml in those without disease (p < 0.001). Subjects with disease from an anatomic defect, a longer hospital stay, or who died had higher BNP. A BNP of 170 pg/ml yielded a sensitivity of 94% and specificity of 73% in the neonatal group and 87% and 70% in the older age group, respectively, using a BNP of 41 pg/ml. CONCLUSIONS: BNP is a reliable test to diagnose significant structural or functional CVD in children. Optimal cutoff values are different from adult values.

Author information

Author/s: Law, Yuk M (YM); Hoyer, Andrew W (AW); Reller, Mark D (MD); Silberbach, Michael (M);

Affiliation: Pediatric Cardiology, Department of Pediatrics, Children's Hospital and Regional Medical Center, University of Washington, Seattle, Washington 98105, USA. yuk.law(-atsign-)seattlechildrens.org

Journal and publication information

Publication Type: Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't

Journal: Journal of the American College of Cardiology (J Am Coll Cardiol), published in United States. (Language: eng)

Reference: 2009-Oct; vol 54 (issue 15) : pp 1467-75

Dates: Created 2009/10/02; Completed 2009/10/29;

PMID: 19796740, status: MEDLINE (last retrieval date: 10/29/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: J Am Coll Cardiol. 2009 Oct 6;54(15):1476-7. (PMID: 19796741)

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