Correlation of heart failure severity and N-terminal pro-brain natriuretic peptide level in children
Abstract: Heart failure
affects morbidity and mortality in children with heart disease. There is no
single, specific test to diagnose heart failure. The modified Ross Reithmann
scoring system has been used to classify heart failure severity, but it is
limited due to its subjectivity. The N-terminal pro-brain natriuretic peptide
(NT-proBNP) is secreted by the ventricles during heart failure. It has been
suggested as a possible marker for diagnosing heart failure.
Objective To investigate the correlation between heart failure severity
and plasma NT-proBNP concentration in children aged one month to 14 years.
Methods A cross-sectional study was performed in the Pediatrics
Department of Mohammad Hoesin Hospital from July to September 2015 on children
with congestive heart failure, aged one month to 14 years. Heart failure
severity was assesed using the modified Ross Reithmann scoring system. Plasma
NT-proBNP measurements were done in all subjects. Statistical analysis was done
by Spearman’s test.
Results Subjects’ median plasma
NT-proBNP concentration was 1,703 pg/mL (range 310-9,000 pg/mL). The NT-proBNP
level and severity of heart failure had a significant, positive correlation
(r=0.87; P<0.001). The NT-proBNP minimum levels in subjects with mild,
moderate and severe heart failure were 310 pg/mL, 1,251 pg/mL, and 2,610 pg/mL,
respectively.
Conclusion Plasma NT-proBNP level has a significant, positive correlation
with the severity of heart failure in children. As such, NT-proBNP level may be
useful as a biochemical marker for the diagnosis and grading of the severity of
heart failure in children.
Keywords: heart failure;
modified Ross Reithmann score; NTproBNP
Author: Yasmien Mahrani, Ria
Nova, Masagus Irsan Saleh, Kemas Yakub Rahadianto
Journal Code: jpkedokterangg160218
