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Elevated proBNP levels are associated with disease severity, cardiac dysfunction, and mortality in congenital

Vikas S Gupta1, Neil Patel2, Florian Kipfmueller3

  • 1Department of Pediatric Surgery, McGovern Medical School at the University of Texas Health Science Center and Children's Memorial Hermann Hospital, 6431 Fannin St, MSB 5.528, Houston, TX 77030, United States.

Journal of Pediatric Surgery
|March 22, 2021
PubMed

Insights

Elevated pro-b-type natriuretic peptide (proBNP) levels in congenital diaphragmatic hernia (CDH) patients indicate higher-risk defects, cardiac dysfunction, and mortality. ProBNP shows promise as a biomarker for CDH-related heart issues.

Area of Science:

  • Pediatric Cardiology
  • Neonatal Research
  • Biomarker Discovery

Background:

  • Congenital diaphragmatic hernia (CDH) significantly impacts patient outcomes due to cardiac dysfunction.
  • Pro-b-type natriuretic peptide (proBNP) is a recognized prognosticator for heart failure and cardiomyopathy.
  • This study investigated the association between proBNP levels and cardiac function in CDH patients.

Purpose of the Study:

  • To determine if proBNP levels correlate with ventricular dysfunction in congenital diaphragmatic hernia (CDH).
  • To assess the relationship between proBNP levels and the severity of CDH defects.
  • To evaluate proBNP as a potential biomarker for cardiac dysfunction and mortality in CDH.

Main Methods:

  • Analysis of proBNP values from 2,337 patients within the CDH Study Group (CDHSG) registry (2015-2019).
  • Echocardiograms were used to assess ventricular function within the first 48 hours of life.
  • Comparison of proBNP levels across different CDH defect severity stages and clinical outcomes.

Main Results:

  • Elevated proBNP levels were observed in patients with high-risk CDH defects (Stage C/D) compared to low-risk defects (Stage A/B).
  • Significantly higher proBNP levels were found in patients who died and those with ventricular dysfunction.
  • While proBNP showed associations, it lacked both sensitivity and specificity for diagnosing ventricular dysfunction (AUC=0.61).

Conclusions:

  • Elevated proBNP levels in CDH patients are linked to severe defects, cardiac dysfunction, and increased mortality.
  • ProBNP demonstrates potential as a valuable biomarker for identifying cardiac dysfunction in congenital diaphragmatic hernia.
  • Further research may refine proBNP's role in managing CDH-associated cardiovascular complications.
Abstract

Keywords:
CDH study groupCardiac dysfunctionCongenital diaphragmatic herniaPulmonary hypertensionRegistryproBNP Biomarkers

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