N-terminal pro-B-type natriuretic peptide levels in acute versus chronic left ventricular dysfunction.
OBJECTIVE
To determine whether acute left ventricular dysfunction (LVD) causes significantly higher elevation of N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels than comparable chronic LVD.


METHODS
Plasma levels of NT-proBNP were measured in 10 pediatric patients diagnosed with acute LVD, in 7 pediatric patients with stable chronic dilated cardiomyopathy (DCM) and comparable levels of echocardiographic dysfunction, and during 5 episodes of acute exacerbation in patients with heart failure. Levels were compared using Mann-Whitney and analysis of variance for rank tests.


RESULTS
Plasma levels of NT-proBNP were excessively elevated in patients with acute LVD in the first 24 to 48 hours of hospitalization (median level, 65,600 pg/mL), and were significantly higher than those in patients with chronic DCM (median level, 1125 pg/mL; P < .0001). NT-proBNP levels decreased in the subsequent days in 83% of patients with serial measurements. The NT-proBNP levels were lower In 5 episodes of acute exacerbation than in acute LVD (median level, 7185 pg/mL; P < .003).


CONCLUSIONS
Acute LVD is associated with elevated NT-proBNP level in children.
Fried
Iris
I
Department of Pediatrics, Hadassah-The Hebrew University Medical Center, Jerusalem, Israel.
Bar-Oz
Benjamin
B
Perles
Zeev
Z
Rein
Azaria J J T
AJ
Zonis
Zeev
Z
Nir
Amiram
A
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D009202:Cardiomyopathies / Q000097:blood; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D006333:Heart Failure / Q000097:blood; D006760:Hospitalization; D006801:Humans; D007223:Infant; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000097:blood*
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain