title: N-terminal pro-brain natriuretic peptide level as a screening tool for cardiac involvement in paediatric diseases of extracardiac origin.
abstract: BACKGROUND
  Serum concentrations of N-terminal natriuretic pro-brain natriuretic peptide (NT-proBNP) correlate well with the severity of cardiac disease in children and adults. There are also paediatric illnesses of extracardiac origin that may cause deterioration of the cardiac function in some patients (pts). A high NP level can signify a concomitant cardiac involvement in respiratory distress, or secondary to a systemic disease.
  
  
  OBJECTIVE
  To assess the potential of NT-proBNP as a screening tool for cardiac involvement in paediatric diseases of extracardiac origin.
  
  
  METHODS
  A literature search was performed in PubMed for the relevant studies with the subject brain natriuretic peptide (BNP) and NT-proBNP from 1995 to 2010 with stress on characteristics of the natriuretic peptides, paediatric reference values and systemic paediatric diseases with potential influence on the myocardial performance. The main focus has been NT-proBNP being the most stable NP and correlating well with BNP.
  
  
  RESULTS
  Most studies agree that a high NT-proBNP level indicates cardiac dysfunction in different systemic diseases such as thalassemia and cystic fibrosis or in pts after chemotherapy. In special clinical scenarios as sepsis or respiratory distress, NT-proBNP helps to narrow down the differential diagnosis or can be used for risk stratification.
  
  
  CONCLUSIONS
  NT-proBNP can serve as a screening tool in various primarily non-cardiac paediatric diseases. Together with the clinical picture, a high level suggests further assessment by a paediatric cardiologist.
authors.affiliation: Department of Paediatrics, Children's Hospital, London Health Science Centre, University of Western Ontario, 800 Commissioners Road East, London, ON N6A 5W9, Canada. Eva.Welisch@lhsc.on.ca
authors.forename: Eva
authors.initials: E
authors.lastname: Welisch
authors.forename: Kambiz
authors.initials: K
authors.lastname: Norozi
authors.forename: Ralf
authors.initials: R
authors.lastname: Rauch
mesh_terms: D002648:Child; D003937:Diagnosis, Differential; D006331:Heart Diseases / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008403:Mass Screening / Q000379:methods; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D012720:Severity of Illness Index
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain