N-terminal pro brain natriuretic peptide and cardiac function in doxorubicin administered pediatric patients.
OBJECTIVE
Assess the use of N terminal pro brain natriuretic peptide (NT-pro BNP) to early diagnose ventricular dysfunction in doxorubicin-administered children.


METHODS
Fifty-five cancer patients who received accumulative dose of doxorubicin <300 mg/m2 (group 1), 49 cases with accumulative dose > or = 300 mg/m2 (group 2) and 52 cases as a control group (group 3) were included in the study. Electrocardiogram, chest roentgenogram, echocardiogram, and serum NT-pro BNP were studied.


RESULTS
At age 1-10 years, there were significantly higher NT-pro BNP in group 2 than group 1 (384 +/- 291 vs. 92.2 +/- 89 pg/ml; p = 0.001), and than group 3 (79 +/- 92 pg/ml; p = 0.001). Patients with NT-pro BNP level > 1 SD of the control group were more likely to have abnormal > or = 2 echocardiographic parameters of left ventricular diastolic dysfunction than patients with NT-pro BNP < or = 1 SD (OR = 3.8, 95% CI 1.18-12.5). Patients in group 2 were more likely to have abnormal > or = 2 parameters of left ventricular diastolic dysfunction than patients in group 1 (OR = 2.8, 95% CI 1.07-7.7) and more likely to have NT-pro BNP >1 SD than group 1 (OR = 8, 95% CI 1.96-38.4). There were association of NT-pro BNP > 1 SD, accumulative dose of doxorubicin > or = 300 mg/m2, and early left ventricular diastolic dysfunction by echocardiogram.


CONCLUSIONS
Serum NT-pro BNP > 1 SD has a high probability to diagnose early doxorubicin-induced cardiomyopathy in patient 1-10 years old.
Hongkan
Wasana
W
Division of Cardiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Soongswang
Jarupim
J
Veerakul
Gavivann
G
Sanpakit
Kleebsabai
K
Punlee
Kesaree
K
Rochanasiri
Wandee
W
Udompunturak
Suthipol
S
D000704:Analysis of Variance; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D002648:Child; D003430:Cross-Sectional Studies; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006334:Heart Function Tests; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D013902:Radiography, Thoracic; D018709:Statistics, Nonparametric; D018754:Ventricular Dysfunction / Q000097:blood* / Q000139:chemically induced*
D000903:Antibiotics, Antineoplastic; D015415:Biomarkers; D020097:Natriuretic Peptide, Brain; D004317:Doxorubicin