Clinical and Biochemical Assessments of Circulating B-Type Natriuretic Peptide as a Useful Marker in Pediatric Cardiac Patients

Although the left ventricle is the major site of BNP secretion in response to cardiac pressure or volume overload, the myocytes of both atria and ventricles secrete B- type natriuretic peptide (BNP). This study aimed to assess and compare the plasma levels of BNP in common pediatric cardiac diseases to clarify its pathophysiological role and evaluate its possible diagnostic and prognostic utility in pediatric patients with congenital heart disease (CHD), and heart failure (HF).
The study is a prospective, case-control research including 131 pediatric patients selected from Pediatric Department of South Valley University Hospitals in Qena, Egypt, with a variety of cardiac diseases and 70 healthy controls. The patients were categorized into 4 groups: 61 newly diagnosed pediatric patients with CHD, 30 patients with HF, 20 pediatric patients with cardiomyopathy (CM), and 20 children with rheumatic heart disease (RHD). Clinical and echocardiographic assessments for the pediatric patients were performed. Bioassays of plasma BNP using commercially available ELISA assay kits were performed to the study the participants.
The median plasma BNP levels were significantly higher in the CHD, HF and CM groups than the RHD and control groups, with p<0.001 for all groups with non-significant differences between both RHD and control groups. BNP levels did not significantly differ in patients with PDA or multiple cardiac anomalies vs. the controls (p˃0.05).
The validity of plasma BNP in diagnosing HF was significantly superior to its utility in predicting CHD among pediatric patients.