NT-proBNP concentrations indicate cardiac disease in pediatric patients

Objective To test the performance of N-terminal pro B-type natriuretic peptide to distinguish from cardiac and non-cardiac disease in the pediatric patient population. Method NT-proBNP concentrations were retrospectively analysed in 102 pediatric patients (median age: 5.96 years; 0–18 years) with cardiac diseases comprising left-to-right-shunt lesions (n = 42), left heart lesions (n = 47) and right heart lesions (n = 13) and in 65 pediatric patients (median age: 3.37 years; 0.03–18 years) with acute infection, minor trauma or neurological disorder. Results NT-proBNP levels between patients without heart disease and patients with heart disease differed significantly with a median NT-proBNP value of 224.9 ng/l, 108.7 ng/l–945.6 ng/l (25th–75th percentile) versus 76.7 ng/l, 35.0 ng/l–122.4 ng/l, p < 0.0001. The diagnostic performance of NT-proBNP to differentiate between patients with and without cardiac diseases was high with an area under curve of 0.81 (95% confidence intervals 0.75–0.87). At a cut-off value of 134 ng/l the specificity was 83% (95% CI: 74–92%). The presence of heart failure (p < 0.0001) had a significant impact on NT-proBNP concentrations. Conclusions NT-proBNP measurement is a helpful addition to identify pediatric patients with heart disease.