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Atrial natriuretic peptide as a marker of heart failure in children with left ventricular volume overload

Alyaa A Kotby1, Khaled H Taman, Heba Tallah A Sedky

  • 1Faculty of Medicine, Department of Pediatric, Ain Shams University, Cairo, Egypt.

Journal of Paediatrics and Child Health
|January 3, 2013
PubMed

Insights

Atrial natriuretic peptide (ANP) levels are elevated in children with left ventricular (LV) volume overload, regardless of the heart failure cause. ANP can distinguish between clinical heart failure and quiescent states and monitor treatment response.

Area of Science:

  • Pediatric Cardiology
  • Biomarkers in Heart Failure
  • Cardiovascular Physiology

Background:

  • Left ventricular (LV) volume overload is a significant concern in pediatric heart failure.
  • Differentiating the etiology of heart failure in children can be challenging.
  • Atrial natriuretic peptide (ANP) is a hormone released by the heart in response to stretch.

Purpose of the Study:

  • To investigate the utility of atrial natriuretic peptide (ANP) in identifying the cause of heart failure in pediatric patients with LV volume overload.
  • To assess ANP's ability to differentiate between various etiologies of heart failure and its correlation with disease severity.

Main Methods:

  • The study included 48 children with LV volume overload (rheumatic heart disease, congenital heart disease, dilated cardiomyopathy) and 12 healthy controls.
  • Evaluated New York Heart Association (NYHA) class, LV dimensions, and function using echocardiography.
  • Measured serum ANP levels using ELISA before and after treatment with angiotensin-converting enzyme inhibitors.

Main Results:

  • Serum ANP levels were significantly higher in all patient groups compared to controls (P < 0.001).
  • ANP levels correlated with NYHA class and decreased significantly after treatment (P < 0.001).
  • Changes in ANP levels correlated with changes in LV end-diastolic diameter (r = 0.3, P < 0.05).

Conclusions:

  • ANP is elevated in pediatric LV volume overload irrespective of the heart failure etiology.
  • ANP can differentiate children with clinical heart failure from those in a quiescent state, even without evident systolic dysfunction.
  • ANP serves as a valuable biomarker for monitoring LV remodeling during treatment.
Abstract

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