Clinical value of plasma B‑type natriuretic peptide assay in pediatric pneumonia accompanied by heart failure

Hu,Dan; Liu,Yang; Tao,Huixian; Gao,Jinping

doi:10.3892/etm.2015.2781

Clinical value of plasma B‑type natriuretic peptide assay in pediatric pneumonia accompanied by heart failure

Authors:
- Dan Hu
- Yang Liu
- Huixian Tao
- Jinping Gao
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Affiliations: Department of Pediatrics, The First People's Hospital of Zhangjiagang, Zhangjiagang, Jiangsu 215600, P.R. China, Department of Pediatrics, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
Published online on: October 1, 2015 https://doi.org/10.3892/etm.2015.2781
Pages: 2175-2179

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Abstract

Previous studies have shown that B-type natriuretic peptide (BNP) is useful in differentiating cardiac from pulmonary causes of dyspnea in adults. To date, international guidelines have recommended measurements of circulating BNP as a biomarker for diagnostic and prognostic purposes, as well as therapeutic monitoring, in adults with cardiac diseases, particularly those suffering from acute and chronic heart failure (HF). The aim of the present study was to investigate the differential diagnostic and therapeutic analysis of BNP levels assayed in pediatric pneumonia accompanied by HF. The clinical data of 80 patients with pneumonia, aged 1‑3 years, were analyzed. The patients were divided into two groups: Simple pneumonia (46 cases) and pneumonia accompanied by HF (34 cases). All patients underwent two plasma BNP assays: The first one upon admission to the hospital and the second one prior to discharge. The plasma BNP levels of 20 healthy children were used as the negative control. Plasma BNP levels were measured using the Triage® BNP automated immunoassay systems and reagents. Statistical analysis showed that the plasma BNP levels of the patients upon admission were higher in the pneumonia accompanied by HF group compared with those in the simple pneumonia group (750±120 vs. 135±50 pg/ml; P<0.05). In addition, in the pneumonia accompanied by HF group, the plasma BNP levels of the patients were higher upon admission to the hospital than they were prior to discharge (750±120 vs. 115±45 pg/ml; P<0.05); therefore, plasma BNP may comprise a sensitive diagnostic and therapeutic evaluative marker for pediatric patients with pneumonia accompanied by HF. This finding could prove invaluable in the clinical diagnosis and treatment of the disease.

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1	Clerico A, Giannoni A, Vittorini S, et al: Thirty years of the heart as an endocrine organ: Physiological role and clinical utility of cardiac natriuretic hormones. Am J Physiol Heart Circ Physiol. 301:H12–H20. 2011. View Article : Google Scholar : PubMed/NCBI
2	Cantinotti M, Giovannini S, Murzi B and Clerico A: Diagnostic, prognostic and therapeutic relevance of B-type natriuretic hormone and related peptides in children with congenital heart diseases. Clin Chem Lab Med. 49:567–580. 2011. View Article : Google Scholar : PubMed/NCBI
3	Hunt PJ, Richards AM, Nicholls MG, et al: Immunoreactive amino-terminal pro-brain natriuretic peptide (NT-PROBNP): A new marker of cardiac impairment. Clin Endocrinol (Oxf). 47:287–296. 1997. View Article : Google Scholar : PubMed/NCBI
4	Mair J, Friedl W, Thomas S and Puschendorf B: Natriuretic peptides in assessment of left-ventricular dysfunction. Scand J Clin Lab Invest Suppl. 230:132–142. 1999. View Article : Google Scholar : PubMed/NCBI
5	McKelvie RS, Moe GW, Ezekowitz JA, et al: The 2012 Canadian Cardiovascular Society heart failure management guidelines update: Focus on acute and chronic heart failure. Can J Cardiol. 29:168–181. 2013. View Article : Google Scholar : PubMed/NCBI
6	McMurray JJ, Adamopoulos S, Anker SD, et al: ESC Committee for Practice Guidelines: ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: 2012 The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J. 33:1787–1847. 2012. View Article : Google Scholar : PubMed/NCBI
7	Metra M, Ponikowski P, Dickstein K, et al: Advanced chronic heart failure: A position statement from the Study Group On Advanced Heart Failure of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 9:684–694. 2007. View Article : Google Scholar : PubMed/NCBI
8	Heart Failure Society of America. Lindenfeld J, Albert NM, Boehmer JP, et al: HFSA 2010 comprehensive heart failure practice guideline. J Card Fail. 16:e1–e194. 2010. View Article : Google Scholar : PubMed/NCBI
9	Felker GM, Adams KF Jr, Konstam MA, et al: The problem of decompensated heart failure: Nomenclature, classification and risk stratification. Am Heart J. 145(Suppl 2): 18–25. 2003. View Article : Google Scholar
10	Arnold LM, Crouch MA, Carroll NV and Oinonen MJ: Outcomes associated with vasoactive therapy in patients with acute decompensated heart failure. Pharmacotherapy. 26:1078–1085. 2006. View Article : Google Scholar : PubMed/NCBI
11	Kliegman RM, Stanton BMD, St. Geme J, Schor N and Behrman RE: Part XIX, Respiratory System. Nelson Textbook of Pediatrics (19th). (Philadephia, PA). Saunders (Elsevier). 2015.
12	Maisel A, Krishnaswamy P, Nowak RM, et al: Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med. 347:161–167. 2002. View Article : Google Scholar : PubMed/NCBI
13	Morrison LK, Harrison A, Krishnaswamy P, et al: Utility of a rapid B-natriuretic peptide assay in differentiating congestive heart failure from lung disease in patients presenting with dyspnea. J Am Coll Cardiol. 39:202–209. 2002. View Article : Google Scholar : PubMed/NCBI
14	Mair J, Hammerer-Lercher A and Puschendorf B: The impact of cardiac natriuretic peptide determination on the diagnosis and management of heart failure. Clin Chem Lab Med. 39:571–588. 2001. View Article : Google Scholar : PubMed/NCBI
15	de Bold AJ, Borenstein HB, Veress AT, et al: A rapid and potent natriuretic response to intravenous injection of atrial myocardial extracts in rats. Life Sci. 28:89–94. 1981. View Article : Google Scholar : PubMed/NCBI
16	Saito Y, Nakao K, Itoh H, et al: Brain natriuretic peptide is a novel cardiac hormone. Biochem Biophys Res Commun. 158:360–368. 1989. View Article : Google Scholar : PubMed/NCBI
17	Burnett JC, Kao PC, Hu DC, et al: Atrial natriuretic peptide elevation in congestive heart failure in human. Science. 231:1145–1147. 1986. View Article : Google Scholar : PubMed/NCBI
18	Frankenstein L, Nelles M, Slavutsky M, et al: Beta-blockers influence the short-term and long-term prognostic information of natriuretic peptides and catecholamines in chronic heart failure independent from specific agents. J Heart Lung Transplant. 26:1033–1039. 2007. View Article : Google Scholar : PubMed/NCBI
19	Di Angelantonio E, Chowdhury R, Sarwar N, et al: B-type natriuretic peptides and cardiovascular risk: Systematic review and meta-analysis of 40 prospective studies. Circulation. 120:2177–2187. 2009. View Article : Google Scholar : PubMed/NCBI
20	Doust JA, Pietrzak E, Dobson A and Glasziou P: How well does B-type natriuretic peptide predict death and cardiac events in patients with heart failure: systematic review. BMJ. 330:6252005. View Article : Google Scholar : PubMed/NCBI
21	Vesbianu D, Vesbianu C, Bernstein P, et al: Plasma brain natriuretic peptide-an independent predictor of mortality and rehospitalization in congestive heart failure-a meta-analysis. World Heart J. 1:349–354. 2008.
22	Oremus M, Raina PS, Santaguida P, et al: A systematic review of BNP as a predictor of prognosis in persons with coronary artery disease. Clin Biochem. 41:260–265. 2008. View Article : Google Scholar : PubMed/NCBI