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Plasma B-type natriuretic peptide study in children with severe enterovirus 71 infection: a pilot study
Sheng-Ling Jan1, Shing-Jong Lin, Yun-Ching Fu
1Department of Pediatrics, Taichung Veterans General Hospital, 160, Sec. 3, Chung-Kang Road, Taichung 40705, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
Insights
Plasma B-type natriuretic peptide (BNP) effectively detects cardiac involvement in children with severe enterovirus 71 (EV71) infections. This biomarker shows high sensitivity and specificity for identifying acute heart failure in these critical cases.
Area of Science:
- Pediatric Infectious Diseases
- Cardiology
- Biomarker Research
Background:
- Severe enterovirus 71 (EV71) infections in children can lead to acute heart failure.
- B-type natriuretic peptide (BNP) is recognized as a key biomarker for myocardial stress.
Purpose of the Study:
- To evaluate plasma BNP as a diagnostic tool for detecting cardiac involvement in children with severe EV71 infections.
Main Methods:
- A comparative study involving healthy controls, EV71 patients with central nervous system involvement, and EV71 patients with cardiopulmonary failure.
- Statistical analysis of demographic and laboratory data, focusing on plasma BNP levels.
Main Results:
- Group 3 (cardiopulmonary failure) showed significantly higher troponin I, CK-MB, and BNP levels compared to other groups.
- Median BNP levels were <5 pg/ml (controls), 9.5 pg/ml (CNS involvement), and 238 pg/ml (cardiopulmonary failure).
- A BNP cut-off of 100 pg/ml achieved 100% sensitivity and specificity for detecting acute heart failure in severe EV71 infections.
Conclusions:
- Children with severe EV71 infections exhibit varying degrees of myocardial stress.
- Plasma BNP is a sensitive and reliable biomarker for identifying cardiac involvement in pediatric EV71 infections.
Objectives:
Severe enterovirus 71 (EV71) infections in children can result in acute heart failure. B-type natriuretic peptide (BNP) is a good biomarker of myocardial stress. The purpose of this study was to use plasma BNP for the detection of EV71 infection with cardiac involvement.
Methods:
Patients with severe EV71 infections and healthy control subjects were studied: group 1 (n=30), normal controls; group 2 (n=20), EV71 infection with central nervous system involvement; and group 3 (n=3), EV71 infection with cardiopulmonary failure. The demographic and laboratory data including plasma BNP levels were analyzed statistically.
Results:
All group 2 patients recovered completely without neurological sequelae, and all group 3 patients survived without cardiac complications. Group 3 patients had higher troponin I, MB fraction of creatine kinase, and BNP levels than patients of the other groups. The median BNP values were <5 pg/ml in group 1, 9.5 pg/ml in group 2, and 238 pg/ml in group 3. Using a BNP cut-off value of 100 pg/ml to identify cases with severe EV71 infection and acute heart failure, the sensitivity and specificity were both 100%.
Conclusions:
Children with severe EV71 infections have varying degrees of myocardial stress. Plasma BNP would be a sensitive and reliable biomarker for the detection of cardiac involvement in children with severe EV71 infections.
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