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Plasma brain natriuretic peptide concentrations in healthy children from birth to adolescence: marked and rapid
M Yoshibayashi1, T Kamiya, Y Saito
1Department of Pediatrics, National Cardiovascular Center, Osaka, Japan.
Insights
Plasma brain natriuretic peptide (BNP) is significantly higher in newborns than adults, decreasing rapidly after birth. This suggests a unique role for BNP in perinatal circulatory adjustments distinct from atrial natriuretic peptide (ANP).
Area of Science:
- Pediatrics
- Cardiology
- Neonatology
Background:
- Plasma brain natriuretic peptide (BNP) and atrial natriuretic peptide (ANP) are crucial hormones in cardiovascular regulation.
- Understanding their developmental changes in neonates and children is essential for diagnosing and managing cardiovascular conditions.
Purpose of the Study:
- To establish normal plasma BNP concentration ranges in healthy children from birth through adolescence.
- To investigate the developmental trajectory of plasma BNP and ANP concentrations post-birth.
- To elucidate the distinct physiological roles of BNP and ANP during perinatal circulatory transition.
Main Methods:
- Plasma BNP and ANP concentrations were measured in 58 healthy children (birth to adolescence) and 20 neonates using sensitive immunoradiometric assays.
- Umbilical vein blood samples were collected from healthy neonates.
- Concentrations were analyzed across different age groups, including the immediate postnatal period.
Main Results:
- Plasma BNP concentration was highest at birth (56.7 +/- 49.6 fmol/ml), approximately 25-30 times higher than adult levels.
- BNP levels rapidly decreased post-birth, reaching adult levels by 3 months of age.
- The ratio of BNP to ANP was highest at birth and declined to adult levels by 3 months, while ANP levels showed no significant difference from umbilical vein levels.
Conclusions:
- Neonatal plasma BNP exhibits a marked, rapid, and preferential increase immediately after birth.
- These findings suggest a distinct physiological role for BNP in perinatal circulatory adaptation, separate from ANP.
- The study provides critical reference ranges for BNP in pediatric populations.
Abstract:
The aim of the present study is to establish the normal range and to determine the developmental changes of plasma brain natriuretic peptide (BNP) concentrations in children. We measured plasma BNP concentrations as well as atrial natriuretic peptide (ANP) concentrations in 58 healthy children from birth to adolescence and in the umbilical vein of 20 healthy neonates using highly sensitive immunoradiometric assays. The plasma BNP concentration was the highest at 0 days of age and descended through maturation to be almost constant and to be at the adult level at 3 months of age. The plasma BNP concentration at 0 days of age (56.7 +/- 49.6 fmol/ml; mean +/- SD) was 25 to 30 times higher than the adult level and 21 times higher than that in the umbilical vein (2.7 +/- 1.4 fmol/ml). The plasma ANP concentration at 0 days of age was not significantly different from that in the umbilical vein. The ratio of BNP to ANP was also the highest at 0 days of age (1.39 +/- 0.72) and decreased through maturation to be at the adult level at 3 months of age. Thus, the plasma BNP concentration in healthy subjects showed a marked, rapid and preferential increase immediately after birth, suggesting that BNP has a physiological role distinct from that of ANP in the perinatal circulatory changes from fetus to neonate.