Biomonitors of cardiac injury and performance: B-type natriuretic peptide and troponin as monitors of hemodynamics and oxygen transport balance

Abstract

(class IIb, level of evidence B): The use of B-type natriuretic peptide and/or troponin measurements in the evaluation of hemodynamics and postoperative outcome in pediatric cardiac patients may be beneficial.

Assessment of Myocardial Function and Injury by Echocardiography and Cardiac Biomarkers in African Children With Severe Plasmodium falciparum Malaria*

“…No patients had markedly elevated levels of BNP (range, 22–386 pg/mL). BNP values in our cohort were above the reference range for healthy children and were consistent with levels seen in critical illness ( 19 , 21 , 23 , 24 , 30 , 32 , 34 , 35 ). Commonly used cutoff values for BNP in children with cardiac dysfunction are variable; however, the elevation in BNP seen in our cohort was below than those commonly used to identify LV dysfunction ( 25 , 26 , 36 , 37 ).…”

Micro-RNA-208a, -208b, and -499 as Biomarkers for Myocardial Damage After Cardiac Surgery in Children

“…Several miRNAs have been previously shown to correlate with troponin in various clinical settings (14,20,23), and we provide an additional setting in which such a correlation is observed. We note, however, that cTn suffers from some limitations as a biomarker for myocardial damage: it is elevated in states of impaired renal function and in neonates (24), and its typical release pattern is rather slow (13,17). Further studies are needed to determine whether miRNA-208a, -208b, and -499 demonstrate an advantage over troponin as biomarkers for myocardial injury in clinical use.…”

Brain Natriuretic Peptide Predicting Outcome After Congenital Heart Surgery … Are We There Yet?*

“…This bottom-up approach develops a sense of shared ownership and accountability across team members, thus helping ensure better adoption of the intervention(s) and enhancing sustainability. Others have used this multidisciplinary bottom-up team approach to reduce hospital-acquired infections (6)(7)(8)(9)(10). We believe some of Esteban's success can be attributed to this approach.…”

“…Is BNP a useful prognostic biomarker for pediatric cardiac surgical patients? Several recent studies suggest perioperative natriuretic peptide levels may prospectively identify children likely to have a poor outcome or a complicated postsurgical course (4)(5)(6)(7)(8)(9)(10).…”