Using N-terminal pro-B-type natriuretic peptide to diagnose cardiac abnormalities in children with dyspneaen with dyspnea
Abstract: Dyspnea could be
caused by various reason, one of which is the presence of cardiac abnormality.
Physical examination sometimes difficult to distinguish breath caused by heart
abnormalities, especially small children, so we need another way to find out.
Objective. To evaluate whether the examination of NT-proBNP levels can be
used as a screening tool to diagnose cardiac abnormality in children presenting
with dyspnea.
Methods. A Cross sectional study was conducted from August to October
2015 on pediatric patients aged 1 month to 18 years presenting with dyspnea in
pediatric ward Mohammad Hoesin Hospital Palembang. All subjects performed blood
sampling for NT-proBNP examination and echocardiography to assess the presence
of cardiac abnormalities. The diagnostic value analyzed by ROC curve, and
determined the optimal cut-off point, sensitivity and specificity.
Result. We obtained 58 subjects
with median age 9.5 (1-180) months, consisted of 39 subjects with cardiac abnormalities
and 19 subjects without cardiac abnormality. There is a significant difference
(p = 0.002) of NT-proBNP levels in both groups with a median 1,775 (189-9,000) pg/ml vs 759 (245-9,000)
pg/ml. In ROC curve analysis, AUC value was 0.75, and at the optimal cut-off
point 1,235 pg/ml, sensitivity was 74.4% and specificity was 73.7%.
Conclusion. The level of NT-proBNP can be used to diagnose cardiac
abnormalities in children presenting with dyspnea.
Keywords: NT-proBNP; dyspnea;
cardiac abnormality
Author: Zakaria Mukalla, Ria
Nova, Legiran Legiran, Yangtjik Yangtjik
Journal Code: jpkedokterangg170092
