title: Role of the NT-proBNP level in the diagnosis of pediatric heart failure and investigation of novel combined diagnostic criteria.
abstract: The aim of this study was to investigate the modified Ross criteria score and the diagnostic cut-off level for plasmatic amino-terminal pro-brain natriuretic peptide (NT-proBNP) in the diagnosis of pediatric heart failure, by analyzing the receiver operating characteristic (ROC) curve. The plasma NT-proBNP level was measured in 80 children diagnosed with heart failure according to the modified Ross criteria, 80 children with non-cardiogenic dyspnea and 80 healthy children. The NT-proBNP levels were then compared using an F-test. The cut-off score for heart failure in the modified Ross criteria and the diagnostic cut-off level for plasmatic NT-proBNP in pediatric heart failure were determined by ROC curve analysis. The results demonstrated that the NT-proBNP level was markedly increased in 76 of the 80 children with heart failure, and the correlation with the modified Ross criteria was 95%. Based on ROC curve analysis, the diagnosis of pediatric heart failure was most accurate when the modified Ross criteria score was ≥4 and the plasmatic NT-proBNP level was ≥598 ng/l. The NT-proBNP level was normal (0-300 ng/l) in the children with non-cardiogenic dyspnea and the healthy children. Significant differences were observed in the comparison of the three groups (P<0.01). In conclusion, a NT-proBNP level of ≥598 ng/l, combined with a modified Ross criteria score ≥4, is highly diagnostic of heart failure in children.
authors.affiliation: Department of Pediatrics, The Women and Children's Health Care Hospital of Shunde, Shunde, Foshan, Guangdong 528300, P.R. China.
authors.forename: Chun-Wang
authors.initials: CW
authors.lastname: Lin
authors.forename: Xiang-Lin
authors.initials: XL
authors.lastname: Zeng
authors.forename: Shao-Hu
authors.initials: SH
authors.lastname: Jiang
authors.forename: Tong
authors.initials: T
authors.lastname: Wu
authors.forename: Jiang-Ping
authors.initials: JP
authors.lastname: Wang
authors.forename: Jin-Feng
authors.initials: JF
authors.lastname: Zhang
authors.forename: Yang-Hui
authors.initials: YH
authors.lastname: Ou
keywords: amino-terminal pro-B-type natriuretic peptide; children; diagnostic criteria; heart failure