Congenital heart diseaseUsefulness of B-Type Natriuretic Peptide and N-Terminal Pro-B-Type Natriuretic Peptide as Biomarkers for Heart Failure in Young Children With Single Ventricle Congenital Heart Disease
Section snippets
Methods
A single-site cross-sectional observational study using a secondary study base was conducted. All children aged 1 month to 7 years with SV physiology presenting to the University of California San Francisco Pediatric Heart Center from February 2007 to December 2010 were eligible for the present study. The patients were excluded if they had renal failure, trisomy 21, an acute intercurrent illness, a congenital defect that interfered with feeding (e.g., cleft palate, esophageal atresia), or had
Results
We approached 91 patients with a SV who met the inclusion criteria and had presented to the University of California San Francisco Pediatric Heart Center from February 2007 to December 2010 for enrollment. Of the 91 patients, 14 (15%) declined. Of the 77 remaining subjects, 6 (8%) were subsequently excluded because of missing data. Thus, 71 children were studied (Table 2). Of the patients with a single right ventricle, 28 had a hypoplastic left heart (10 with mitral/aortic atresia, 8 with
Discussion
The results of the present study have confirmed a direct relation between clinical HF and BNP levels in young children with SV physiology. We propose a cutpoint of ≥45 pg/ml for determining HF in this patient population. This threshold is distinct from the cutpoint of 100 pg/ml established for adults.2 However, 45 pg/ml is also at least double the previously published normal range observed in similarly aged children with structurally normal hearts (5.1 to 12.1 pg/ml).10 In a small study of
Acknowledgment
We thank the University of California San Francisco pediatric cardiology fellows, the University of California San Francisco Congenital Cardiac Catheterization Laboratory staff, and Kirk Sujishi of the University of California San Francisco Clinical Chemistry Laboratory, for their invaluable assistance with the study.
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This work was supported by funds from Biosite Diagnostic, San Diego, California to Dr. Fineman, and funds from the Lorraine Newman Fund of the University of California, San Francisco, Division of Pediatric Cardiology, a Strategic Opportunity Award from the University of California, San Francisco, Clinical and Translational Science Institute (grant UL RR024131 from the National Institutes of Health/National Center for Research Resources, Bethesda, Maryland), and funds from Roche Diagnostics Corporation, Pleasanton, California to Dr. Bernstein.