Usefulness of Plasma B-type Natriuretic Peptide Assay as a Screening Tool for Infants with Suspected Congenital Heart Disease.

Yoon,  Young Shin; Lee,  Jin; Je,  Bo Kyung; Eun,  So Hee; Kim,  Hyung Jin; Choi,  Byung Min; Park,  Jong Tae; Yoo,  Kee Hwan; Hong,  Young Sook; Choi,  Chang Hee

Original Article

Journal of the Korean Society of Neonatology 2005;12(2):141-149.
Published online November 1, 2005.

Usefulness of Plasma B-type Natriuretic Peptide Assay as a Screening Tool for Infants with Suspected Congenital Heart Disease.

Young Shin Yoon, Jin Lee, Bo Kyung Je, So Hee Eun, Hyung Jin Kim, Byung Min Choi, Jong Tae Park, Kee Hwan Yoo, Young Sook Hong, Chang Hee Choi

¹Department of Pediatrics, Seoul Adventist Hospital, Seoul, Korea.
²Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea. cbmin@korea.ac.kr
³Department of Radiology, College of Medicine, Korea University, Seoul, Korea.
⁴Department of Occupational and Environmental Medicine, College of Medicine, Korea University, Seoul, Korea.

선천성 심장병이 의심되는 영아에서 선별검사로서 혈장 B-type Natriuretic Peptide 검사의 유용성

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Abstract

PURPOSE
B-type natriuretic peptide (BNP) is a cardiac neurohormone secreted predominantly from the ventricle in response to increased left and right ventricular pressure loads as well as volume loads. The aim of our study is to investigate the usefulness of plasma BNP assay as a screening tool for infants with suspected congenital heart disease (CHD). METHODS: Ninety-five infants less than 3 months of age with suspected CHD were enrolled and divided into a healthy control group (n=40) and a CHD group (n=50) according to physical examination, chest X-ray, electrocardiography and echocardiography. The CHD group was divided into the treatment group (n=15), requiring urgent treatment and the observation group (n=35), not requiring any treatment. Plasma BNP concentrations were measured using a commercial kit, Triage BNP(R) test kit. RESULTS: The mean BNP concentration of the CHD group was higher than that of the control group (639+/-1, 147 pg/mL versus 26+/-25 pg/mL, P<0.001). The mean BNP concentration of the treatment group was significantly higher than that of the observation group (1, 732+/-1, 629 pg/mL versus 171+/-229 pg/mL, P<0.001). The area under the Receiver Operating Characteristic curve for the detection of CHD was high: 0.821 (95% CI, 0.737-0.905, P<0.001). The best cut-off value of BNP concentration for the screening of CHD requiring urgent treatment was determined to be 282 pg/mL (sensitivity: 100%, negative predictive value: 100%). CONCLUSION: In infants, the plasma BNP measurement is useful and objective in screening the CHD infant without any specific professional skills. Especially in the outpatient department, it is very helpful to determine CHD infant requiring urgent treatment and thus an efficient consultation can be made to the pediatric cardiologist.

Key Words: B-type natriuretic peptide; Screening tool; Congenital heart disease