Clinical Implications of Serial Serum N-Terminal Prohormone Brain Natriuretic Peptide Levels in the Prediction of Outcome in Children With Dilated Cardiomyopathy

Kim, Geena; Lee, Ok Jeong; Kang, I-Seok; Song, Jinyoung; Huh, June

doi:10.1016/j.amjcard.2013.07.007

Cited by 16 publications

(15 citation statements)

References 18 publications

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“…In our study we found an association between percent changes in the NT-proBNP levels and ACV. It seems from our results and the results of other studies 13, 20 that adverse cardiovascular outcomes are related to BNP/NT-proBNP levels at some time point later than the admission/initial levels. The NT-proBNP levels after admission in some way indicates the adequacy or inadequacy of the medical therapy, thereby differentiating the high-risk patients likely to have adverse cardiovascular events.…”

Section: Discussionsupporting

confidence: 75%

“…In children, Kim et al 13 retrospectively evaluated the utility of serial NT-proBNP levels drawn at presentation and 3 and 6 months after diagnosis in children with primary and acquired dilated cardiomyopathy. They found that the NT-proBNP levels 3 months after diagnosis and not the change in NT-proBNP level (percent or absolute) were predictive of adverse outcome.…”

Section: Discussionmentioning

confidence: 99%

“…10,11 Small studies in children with primary and acquired myocardial dysfunction have found serial monitoring useful in predicting the need for mechanical circulatory support 12 or predicting outcome in patients with dilated cardiomyopathy. 13 This study evaluates the ability of serial NT-proBNP monitoring in children with primary myocardial dysfunction and acute decompensated heart failure (ADHF) to identify high-risk patients and predict outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Serial Measurement of Amino-Terminal Pro-B-Type Natriuretic Peptide Predicts Adverse Cardiovascular Outcome in Children With Primary Myocardial Dysfunction and Acute Decompensated Heart Failure

Medar

Hsu²,

Ushay³

et al. 2015

Pediatric Critical Care Medicine

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Introduction In children, elevated amino terminal pro B-type naturetic peptide (NT-proBNP) levels are associated with impaired heart function. The predictive value of serial monitoring of NT-proBNP levels in acute decompensated heart failure (ADHF) is unclear. Methods This prospective observational study enrolled patients ≤ 21 years with primary myocardial dysfunction and ADHF. NT-proBNP levels were obtained on enrollment (D0), day 2 (D2) and day 7 (D7). Clinical, laboratory and imaging data were collected on enrollment. CV outcome was defined as Heart Transplant (HTx), Ventricular Assist Device (VAD) placement, Extracorporeal Membrane Oxygenation or death at 1 year after admission. NT-proBNP levels and the percent change from D0 to D2 and D0 to D7 were calculated and compared between those with and without adverse cardiovascular (ACV) outcome. Results Sixteen consecutive patients were enrolled. ACV outcome occurred in 6 (37.5%, 4 HTx and 2 VAD). In patients with an ACV outcome, median NT-ProBNP levels at D7 were significantly higher (7,365 Vs. 1,196 pg/ml; p= 0.02) and the percent decline in NT-proBNP was significantly smaller (28% vs. 73%, p=0.02) compared to those without an ACV outcome. ROC curve analysis revealed that a less than 55% decline in NT-proBNP levels at D7 had a sensitivity and specificity of 83% and 90% respectively in predicting an ACV [AUC 0.86, CI (0.68,1.0), p=0.02]. Conclusions In conclusion, children with primary myocardial dysfunction and ADHF, a persistently elevated NT-proBNP and/or a lesser degree of decline in NT-proBNP during the first week of presentation were strongly associated with ACV outcome. Serial NT-proBNP monitoring may allow the early identification of children at risk for worse outcome.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Serial Measurement of Amino-Terminal Pro-B-Type Natriuretic Peptide Predicts Adverse Cardiovascular Outcome in Children With Primary Myocardial Dysfunction and Acute Decompensated Heart Failure

Medar

Hsu²,

Ushay³

et al. 2015

Pediatric Critical Care Medicine

View full text Add to dashboard Cite

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“…Both are markers for hemodynamic overload, especially volume overload [13,34,39]. In the course of dilated cardiomyopathy they reflect the severity of failure with a significantly positive correlation [32,38]. NT-proBNP has the advantage that it is more stable in vitro.…”

Section: Commonly Encounteredmentioning

confidence: 99%

“…In childhood there are some reports on serial measurements in children with dilated cardiomyopathy showing a substantial improvement ( = decrease) of NT-proBNP in patients. A serum NT-proBNP level at 3 months above 681 pg/ml (for the Elecsys 2010, Roche Diagnostics) was associated with a more adverse outcome, such as LVFS < 10 % or cardiac death [32].…”

Section: Commonly Encounteredmentioning

confidence: 99%

Chronic Congestive Heart Failure in Infancy and Childhood: New Aspects of Diagnosis and Treatment

2015

Klin Padiatr

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Congestive heart failure (CHF) is the inability of the heart to meet the metabolic demands of the body. As a disease of the advanced age with a frequency of 1-2% of the population it is rare in infancy and childhood. The incidence ranges from 2.95 (in all US children's hospitals) to 23.2 (University's Childrens Hospital Essen) on 1 000 discharges. Among the diagnostic procedures echocardiography is the primary modality of imaging. Tei-index and tissue-Doppler are more sensitive parameters for LV-dysfunction. BNP/NT-proBNP are age-dependent and can guide the long-term therapy. Treatment in childhood does not differ basically from that in adulthood, recommended by several guidelines, but data regarding the various substances - outlined in detail - are very limited. Here a big work has to be done in future!

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Heart failure from heart muscle disease in childhood: a 5–10 year follow‐up study in the UK and Ireland

et al. 2016

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AimsOur original study, the first national prospective study of new‐onset heart failure from heart muscle disease in children, showed overall 1‐year survival of 82%, and event (death or transplantation)‐free survival of 66%. This study aimed to evaluate 5 + year outcomes of this important cohort.Methods and resultsAll centres in the UK and Ireland with 1‐year event‐free survivors participated (n = 14). Anonymised data based on last hospital attendance and echocardiograms were reviewed. The investigator was blinded to outcome at the time of echo review. Of sixty‐nine 1‐year event‐free survivors, data were obtained on 64, with three lost to follow‐up and two moved abroad. There were three deaths at 2.2, 3.3 and 9.0 years after presentation and one transplant, at 5.2 years. Overall/event‐free survival was 77%/62% at 5 years and 73%/59% at 10 years, respectively. Overall and event‐free survival conditional on 1‐year survival was 94% at 5 years, and 89% at 10 years. For the 60 event‐free survivors, median (range) follow‐up duration was 9.04 (5.0–10.33) years for those still under review (n = 45), or time to discharge 5.25 (0.67–10.0) years (n = 15). Fifty‐eight were in New York Heart Association (NYHA) Class 1, and two in Class 2. Forty‐one out of sixty had normal echocardiograms at last follow‐up. Predictors of better longer‐term outcome were the same as for the original 1‐year follow‐up study, namely, younger age and higher fractional shortening measurement at presentation.ConclusionsChildren who survive the first year following their first presentation with significant heart failure from heart muscle disease have a good longer‐term outcome although there remains a small attrition rate.

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Clinical Implications of Serial Serum N-Terminal Prohormone Brain Natriuretic Peptide Levels in the Prediction of Outcome in Children With Dilated Cardiomyopathy

Cited by 16 publications

References 18 publications

Serial Measurement of Amino-Terminal Pro-B-Type Natriuretic Peptide Predicts Adverse Cardiovascular Outcome in Children With Primary Myocardial Dysfunction and Acute Decompensated Heart Failure

Serial Measurement of Amino-Terminal Pro-B-Type Natriuretic Peptide Predicts Adverse Cardiovascular Outcome in Children With Primary Myocardial Dysfunction and Acute Decompensated Heart Failure

Chronic Congestive Heart Failure in Infancy and Childhood: New Aspects of Diagnosis and Treatment

Heart failure from heart muscle disease in childhood: a 5–10 year follow‐up study in the UK and Ireland

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