NT-proBNP as a Marker for Persistent Cardiac Disease in Children with History of Dilated Cardiomyopathy and Myocarditis |
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Authors: | N Nasser Z Perles AJJT Rein A Nir |
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Institution: | (1) Hebrew University Medical School, Jerusalem, Israel;(2) Medical Center, Pediatric Cardiology Unit, Hadassah, Jerusalem, Israel;(3) Shaare Zedek Medical Center, Pediatric Cardiology Unit, Jerusalem, Israel |
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Abstract: | Children with myocarditis and dilated cardiomyopathy may recover clinically and echocardiographically. Plasma levels of the
N-terminal segment of B-type natriuretic peptide prohormone (NT-proBNP), a sensitive marker for cardiac dysfunction, may reflect
residual cardiac damage in these patients. The purpose of this study was to evaluate NT-proBNP status in pediatric patients
with a history of myocarditis and dilated cardiomyopathy. Cardiac evaluation was performed and the levels of NT-proBNP were
measured in 23 children who had a history of myocarditis or dilated cardiomyopathy. NT-proBNP levels were also measured in
56 age-matched control children. Nine of the 23 patients had evidence of left ventricular dysfunction (DCM group), whereas
14 had none (recovery). NT-proBNP levels were higher in the DCM group (3154 ± 2858 pg/ml) than in the recovery group (122 ± 75
pg/ml, p < 0.001) and the control group (113 ± 96 pg/ml, p < 0.001). There was no difference between the recovery and the control groups (p = 0.45), and none of the recovered patients had a NT-proBNP level higher than the upper limit of normal. The area under the
receiver operating characteristics curve for the diagnosis of persistent left ventricular dysfunction was 0.984. NT-proBNP
levels correlated with echocardiographically derived shortening fraction and with clinical score. NT-proBNP is a good marker
for persistent left ventricular dysfunction in children who have had myocarditis or cardiomyopathy. In this group of patients,
NT-proBNP levels are normal in children who recover echocardiographically, suggesting no residual hemodynamic abnormalities. |
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Keywords: | Dilated cardiomyopathy Myocarditis Left ventricular dysfunction Children natriuretic peptides |
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