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B-type natriuretic peptide predicts disease severity in children with hypertrophic cardiomyopathy

J P Kaski1, M T Tomé-Esteban, S Mead-Regan

  • 1Department of Cardiology, Inherited Cardiovascular Diseases Unit, Great Ormond Street Hospital for Children, London, UK. j.kaski@ucl.ac.uk

Heart (British Cardiac Society)
|December 12, 2007
PubMed

Insights

Plasma B-type natriuretic peptide (BNP) levels correlate with disease severity in children with hypertrophic cardiomyopathy (HCM). BNP testing can aid in assessing disease severity when symptoms are unclear.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Biomarkers

Background:

  • Plasma B-type natriuretic peptide (BNP) levels correlate with disease severity in adults with hypertrophic cardiomyopathy (HCM).
  • In children with HCM, symptoms are unreliable indicators of disease severity.
  • The clinical utility of BNP testing in pediatric HCM has not been previously evaluated.

Purpose of the Study:

  • To assess the relationship between BNP levels and symptoms in children with HCM.
  • To evaluate the correlation of BNP levels with markers of disease severity in pediatric HCM patients.

Main Methods:

  • Assessment of plasma BNP levels in 44 consecutive pediatric HCM patients (age <= 17 years).
  • Clinical evaluation including ECG, echocardiography, and tissue Doppler imaging.
  • Analysis of correlations between BNP levels and clinical/echocardiographic parameters.

Main Results:

  • BNP levels correlated significantly with maximal left ventricular (LV) wall thickness, LV outflow tract gradient, E/Ea(s) ratio, and predicted maximum VO(2).
  • No correlation was found between BNP levels and heart failure symptoms.
  • BNP levels were significantly higher in patients who received an internal cardioverter-defibrillator.
  • BNP was independently associated with E/Ea(s) and maximal LV wall thickness on multivariate analysis.

Conclusions:

  • BNP levels correlate with non-invasive parameters of disease severity in pediatric HCM, including elevated LV filling pressures.
  • BNP may serve as a valuable tool for assessing disease severity in pediatric HCM patients, especially when symptom evaluation is challenging.
Abstract

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