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NT-proBNP as a Marker for Persistent Cardiac Disease in Children with History of Dilated Cardiomyopathy and Myocarditis

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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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Acknowledgments

The authors are in debt to Lea Salpeter for her laboratory assistance and Sherri Aharoni for her technical and secretarial support.

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Authors and Affiliations

  1. Hebrew University Medical School, Jerusalem, Israel

    N. Nasser

  2. Medical Center, Pediatric Cardiology Unit, Hadassah, Jerusalem, Israel

    Z. Perles & A.J.J.T. Rein

  3. Shaare Zedek Medical Center, Pediatric Cardiology Unit, Jerusalem, Israel

    A. Nir

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  1. N. Nasser
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  2. Z. Perles
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  3. A.J.J.T. Rein
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  4. A. Nir
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Correspondence to A. Nir.

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Nasser, N., Perles, Z., Rein, A. et al. NT-proBNP as a Marker for Persistent Cardiac Disease in Children with History of Dilated Cardiomyopathy and Myocarditis. Pediatr Cardiol 27, 87–90 (2006). https://doi.org/10.1007/s00246-005-1027-z

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