title: Reference values of NT-proBNP serum concentrations in the umbilical cord blood and in healthy neonates and children.
abstract: BACKGROUND
  N-terminal brain natriuretic peptide (NT-proBNP) is a neurohormonal substance secreted mainly by the cardiac myocytes of the left ventricle and to a less degree of the left atrium. The releasing mechanism is induced by an increased wall stress on the base of volume or pressure load of the ventricle. The physiologic actions of BNP are prohibition of the sympathetic activity, vasodilatation, natriuresis, diureses and inhibition of the renin-angiotensin system. Because of its high sensitivity and specifity in relation to the left ventricular incompetence, BNP as well as NTproBNP are well accepted markers of ventricular dysfunction. It was the aim of the study to establish reference values of NT-proBNP serum concentrations throughout childhood, in particular in the newborn age group.
  
  
  METHODS
  In a cross sectional study, serum NT-proBNP concentrations were measured by an ElectroChemiLuminescenceImmunoAssay ("ECLIA" Roche) in the umbilical cord blood of 62 healthy full-term neonates and in 222 healthy probands from birth up to the age of 18 years.
  
  
  RESULTS
  The concentration of NT-proBNP in the cord blood samples ranged from 281 to 2595 pg/ml (mean: 818 pg/ml). There was a significant increase in the first days of life followed by a rapid decrease during the first year and a further gradual decrease throughout infancy; beyond the 10(th) year of age normal adult values were approached.
  
  
  CONCLUSIONS
  The knowledge of the normal range of plasma NT-proBNP levels in healthy subjects during childhood serves as a non-invasive marker for differentiation of pathologic conditions such as acute myocarditis, hypertrophic or dilated cardiomyopathy, tachyarrhythmias and pulmonary hypertension.
authors.affiliation: Derpartment of Pediatric Cardiology, University of the Saarland, Homburg/Saar, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Schwachtgen
authors.forename: M
authors.initials: M
authors.lastname: Herrmann
authors.forename: T
authors.initials: T
authors.lastname: Georg
authors.forename: P
authors.initials: P
authors.lastname: Schwarz
authors.forename: N
authors.initials: N
authors.lastname: Marx
authors.forename: A
authors.initials: A
authors.lastname: Lindinger
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D020097:Natriuretic Peptide, Brain; D009419:Nerve Tissue Proteins / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D017678:Sex Distribution
chemical_list: D015415:Biomarkers; D009419:Nerve Tissue Proteins; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain