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

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.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Law YM,Hoyer AW,Reller MD,Silberbach M

doi

10.1016/j.jacc.2009.06.020

subject

Has Abstract

pub_date

2009-10-06 00:00:00

pages

1467-75

issue

15

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(09)02361-4

journal_volume

54

pub_type

杂志文章

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