Abstract
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The Role of N-Terminal proBNP in the Clinic Scoring of Heart Failure due to Dilated Cardiomyopathy in Children
by Nazmi Narin, Berna Hekimoglu, Ali Baykan, Abdullah Ozyurt, Gokmen Zararsiz, Saadettin Sezer, Sertac H. Onan, Mustafa Argun, Ozge Pamukcu, Kazim Uzum
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Background: We aimed to show sensitivity and specificity of NT-ProBNP in demonstrating the degree of cardiac
failure caused by dilated cardiomyopathy (DCMP).
Methods: From January 2006 to July 2012, thirty patients (2 - 168 months) who had DCMP with acute heart failure
and 37 healthy children aged (1 - 168 months) were enrolled in this study. Clinical evaluation was done using a
modified Ross scoring system. Ross scoring was done before and after treatment. Patients with a score of > 2 points
were included in the study. Ross scoring, echocardiographic parameters, serum NT-ProBNP levels and cardiothoracic
index (CTI) were measured before and on the 7th day of treatment. Patients were divided into 3 groups according
to degree of heart failure.
Results: While the change in logNT-ProBNP in the patient group following one-week of treatment was significant
(p < 0.05), there was no marked significance in the changes in EF, FS, LVEDD, LVMIz, and CTI. There was a statistically
significant difference between logNT-ProBNP levels each Ross clinical group not only before treatment
but also on assessment on the 7th day of treatment in the patient group (p < 0.001, Tukey’s and Tamhane’s T2
post-hoc tests). No significant difference was detected between EF, FS, LVEDDs, LVMIz, and CTI and the stages
of acute cardiac failure. The NT-ProBNP levels of patients who became clinically asymptomatic after treatment
but still had left ventricular systolic dysfunction were statistically significant when compared to the control group.
The cut off value to distinguish healthy children from the patients with left ventricular systolic dysfunction caused
by cardiomyopathy was found as174.3 pg/mL.
Conclusions: NT-ProBNP levels are more effective than conventional echocardiographic parameters for clinical
determination of the stage of cardiac failures in children with left ventricular systolic dysfunction due to DCMP.
Therefore, it can be used for determining the treatment and management of such patients. Furthermore, the test
is simple and beneficial, because of its availability in most clinical chemistry laboratories and its advantage of allowing
frequent measurements and assessments.
DOI: 10.7754/Clin.Lab.2013.130145
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