Amino-terminal pro-brain-type natriuretic peptide: heart or lung disease in pediatric respiratory distress?
OBJECTIVE
The aim of this study was to determine whether plasma levels of amino-terminal pro-brain natriuretic peptide (N-BNP) could differentiate between heart failure and lung disease among infants with acute respiratory distress. In addition, our aim was to determine whether plasma levels of N-BNP could be used to monitor the effects of treatment among infants with heart failure.


METHODS
Infants (age range: 1-36 months; median age: 10 months) who presented with respiratory distress underwent physical examination, plasma N-BNP measurement, and echocardiography within 24 hours after admission. Seventeen infants were finally diagnosed with acute heart failure and 18 with acute lung disease. Thirteen healthy infants served as a control group.


RESULTS
Plasma N-BNP levels were significantly higher for the infants with heart failure (median: 18452 pg/mL; range: 5375-99700 pg/mL) than for the infants with lung disease (median: 311 pg/mL; range: 76-1341 pg/mL). Among the infants with heart failure, there was a significant difference in plasma N-BNP levels before and after congestive heart failure treatment.


CONCLUSIONS
Among infants with respiratory distress, plasma N-BNP measurements can differentiate between acute heart failure and lung disease and can be used to monitor the effects of treatment for infants with heart failure.
Cohen
Shlomo
S
Institute of Pulmonology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. advamc@bezeqint.net
Springer
Chaim
C
Avital
Avraham
A
Perles
Zeev
Z
Rein
Azaria J J T
AJ
Argaman
Zvi
Z
Nir
Amiram
A
D000208:Acute Disease; D016022:Case-Control Studies; D002675:Child, Preschool; D004452:Echocardiography; D006333:Heart Failure / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D008171:Lung Diseases / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011446:Prospective Studies; D012131:Respiratory Insufficiency / Q000097:blood / Q000209:etiology*
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain