Serum levels of natriuretic peptides in children with various types of loading conditions.
OBJECTIVE
To evaluate the influence of volume overload of the left (LV) and right ventricle (RV) and pressure overload of LV and restrictive physiology on levels of N-terminal proatriopeptide (ANPN) and N-terminal pro-brain natriuretic peptide (NT-proBNP).


METHODS
We studied 41 children with atrial septal defect (ASD), 35 with patent ductus arteriosus (PDA), 27 with coarctation of the aorta (CoA), 25 with restrictive physiology caused by Mulibrey nanism, and 64 control children. We measured serum concentrations of natriuretic peptides and evaluated ventricular size and function with echocardiography.


RESULTS
In patients with ASD, PDA, and Mulibrey nanism, levels of both ANPN and NT-proBNP were higher than in controls but in children with CoA, only ANPN levels were higher. ANPN levels correlated with RV size in ASD and NT-proBNP levels with LV size in PDA. In patients with restriction, NT-proBNP levels correlated negatively with LV size.


CONCLUSIONS
Correlation between echo measurements and levels of natriuretic peptides varied according to loading condition. Measurement of natriuretic peptide levels provides a supplemental method for non-invasive haemodynamic evaluation of children's heart disease.
Department of Paediatrics, University Hospital of Tampere, Finland. anneli.eerola@fimnet.fi
Anneli
A
Eerola
Eero
E
Jokinen
Jaana I
JI
Pihkala
D000293:Adolescent; D009320:Atrial Natriuretic Factor / Q000097:blood*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D019560:Echocardiography, Three-Dimensional; D005260:Female; D006330:Heart Defects, Congenital / Q000097:blood* / Q000000981:diagnostic imaging; D006801:Humans; D007223:Infant; D008297:Male; D050336:Mulibrey Nanism / Q000097:blood* / Q000000981:diagnostic imaging; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011498:Protein Precursors / Q000097:blood*; D055815:Young Adult
C099254:N-terminal proatrial natriuretic peptide; D010446:Peptide Fragments; D011498:Protein Precursors; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor