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Plasma Concentrations of N-Terminal Brain Natriuretic Peptide in Healthy Children, Adolescents, and Young Adults: Effect of Age and Gender

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Abstract

Children with congenital heart disease need adequate diagnostic classification regarding their cardiovascular status (CVS). N-terminal brain natriuretic peptide (N-BNP) plasma concentration indicates dysfunction of the cardiovascular system and guides decisions concerning treatment and prognosis. Reference values are established for adults, with age-dependent increasing values and higher values in women. To avoid misclassification concerning the CVS, a large group of healthy children and adolescents can be used show the relationship between gender, age, and N-BNP and these can serve as reference values. N-BNP was measured in 434 healthy subjects (240 female and 194 male) with ages ranging from 0 to 32 years without any cardiovascular disease or renal or hepatic impairment. Measurements were performed with an electrochemiluminescence immunoassay from Roche Diagnostics. Mean N-BNP decreased from 12.6 fmol/ml (0–9 years; n = 79) to 9.41 fmol/ml (10–14 years; n = 154) and in adolescents from 6.1 (15–19 years; n = 99) to 4.8 fmol/ml (>19 years; n = 102) in adults (p < 0.05). Mean N-BNP concerning gender did not differ in any age group younger than 19 years. In contrast, the adult female group had 78% higher N-BNP compared to the male group (p < 0.05). There was a significant peak in N-BNP at the age of 12–14 years. This study shows that reference values for N-BNP differed profoundly in children compared to adults and were up to 260% higher in children without any gender difference. Therefore, these reference values will help to avoid CVS misclassification in children for the biomarker N-BNP.

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References

  1. Ationu A, Singer DR, Smith A, et al. (1993) Studies of cardiopulmonary bypass in children: implications for the regulation of brain natriuretic peptide. Cardiovasc Res 27:1538–1541

    Article  CAS  PubMed  Google Scholar 

  2. Best PJ, Berger PB, Miller VM, Lerman A (1998) The effect of estrogen replacement therapy on plasma nitric oxide and endothelin-1 levels in postmenopausal woman. Ann Int Med 128:285–288

    Article  CAS  PubMed  Google Scholar 

  3. Clerico A, Emdin M (2004) Diagnostic accurancy and prognostic relevance of the measurement of cardiac natriuretic peptides: a review. Clin Chem 50:33–50

    Article  CAS  PubMed  Google Scholar 

  4. Cowie MR, Mendez GF (2002) BNP and congestive heart failure. Prog Card Vasc 44:293–321

    Article  CAS  Google Scholar 

  5. Cowley CG, Bradley JD, Shaddy RE (2004) B-type natriuretic peptide levels in congenital heart disease. Pediatr Cardiol 25:336–340

    Article  CAS  PubMed  Google Scholar 

  6. De Bold AJ, Ma KK, Zhang Y, et al. (2001) The physiological and pathophysiological modulation of the endocrine function of the heart. Can J Physiol Pharmacol 79:705–714

    Article  PubMed  Google Scholar 

  7. Gallagher PE, Lenhart JR, Chappell MC, Brosnihan KB (1999) Estrogen regulation of angiotensin-converting enzyme mRNA. Hypertension 33:323–328

    Article  CAS  PubMed  Google Scholar 

  8. Hunt PJ, Richards AM, Nicholls MG, et al. (1997) Immunoreactive amino-terminal pro-brain natriuretic peptide (NT-PROBNP): a new marker of cardiac impairment. Clin Endocrinol Oxford 47:287–296

    Article  CAS  Google Scholar 

  9. International Conference on Harmonisation E9 expert working group. (1994) ICH harmonised tripartite guideline. Statistical principles for clinical trials. Stat Med 18:19.5–1942

    Google Scholar 

  10. Kelly R, Struthers AD (2001) Are natriuretic peptides clinically useful as markers of heart failure ? Ann Clin Biocehm 38: 94–102

    CAS  Google Scholar 

  11. Koch A, Singer H (2003) Normal values of B type natriuretic peptide in infants, children, and adolescents, Heart 89:875–878

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Kuroski de Bold ML (1999) Estrogen, natriuretic peptides and the renin–angiotensin system, Cardiovasc Res 21:1730–1736

    Google Scholar 

  13. Lainchbury JG, Espiner EA, Nicholls MG (1997) Cardiac hormones: diagnosis and therapeutical potential. N Z Med J 110:219–221

    CAS  PubMed  Google Scholar 

  14. Levin E, Gardner D, Samson W (1998) Natriuretic peptides. N Engl J Med 339:321–327

    Article  CAS  PubMed  Google Scholar 

  15. Maisel A (2001) B-type natriuretic peptide levels; a potential novel “white count” for congestive heart failure. J Card Failure 7:183–193

    Article  CAS  Google Scholar 

  16. Maisel A, Krishnaswamy P, Nowak RM, et al (2002) Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med 347:161–167

    Article  CAS  PubMed  Google Scholar 

  17. Mir TS, Laux R, Hellwege HH, (2003) Piasma N-terminal pro-atrial-natriuretic peptide and plasma N-terminal-pro brain natriuretic peptide in healthy neonates: marked and rapid increase after birth. Pediairics 112:896–899

    Article  PubMed  Google Scholar 

  18. Mir TS, Marohn S, Läer S, et al. (2002) Plasma concentrations of N-terminal-pro brain natriuretic peptide in children from neonatal period to adulthood and in children with congestive heart failure. Pediatrics 110:1–6

    Article  Google Scholar 

  19. Redfield MM, Rodeheffer RJ, Jacobsen SJ, et al. (2002) Plasma brain natriuretic peptide concentration: impact of age and gender. J Am Coll Cardiol 40:976–982

    Article  CAS  PubMed  Google Scholar 

  20. Schultz M, Faber J, Kistorp C, et al (2004) N-terminal-pro-B-type natriuretic peptide (NT-pro-BNP) in different thyroid function states. Clin Endocrinol 60:54–59

    Article  CAS  Google Scholar 

  21. Talwar S, Siebenhofer A, Williams B, Ng LL (2000) Influence of hypertension, left ventricular hypertrophy, and left ventricular systolic dysfunction on plasma N terminal pro BMP. Heart 83:278–282

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Troughton RW, Frampton CM, Yandle TG, et al. (2000) Treatment of heart failure guided by plasma aminoterminal brain natriuretic peptide (N-BNP) concentrations. Lancet 355:1126–1130

    Article  CAS  PubMed  Google Scholar 

  23. Wijbenga JAM, Balk AHMM, Boosma F, Man in‘t Veld AJ, Hall C (1999) Cardiac peptides differ in their response to exercise. Implications for patients with heart failure. Eur Heart J 20:1424–1428

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

We are grateful to all the doctors and nurses of the Pediatric University Clinic at the University-Hospital in Hamburg for excellent support of this study. SA is supported by the Kompetenznetzwerk fuer Angeborene Herzfehler, funded by the Bundesministerium fuer Bildung und Forschung (BMBF) of the German Government. SL is a recipient of the Heisenberg Programme of the Deutsche Forschungsgemeinschaft (DFG) in Germany. The ECLIA kits for N-BNP measurements were donated to SL from Roche Diagnostic. Roche gave no financial support and had no input into the study design or the data analysis.

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Authors and Affiliations

  1. Herzzentrum, Klinik und Poliklinik für Kinderkardiologie, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20246 , Hamburg, Germany

    T.S. Mir, J. Falkenberg & J. Weil

  2. Zentrum für Experimentelle Medizin, Institut für Experimentelle und Klinische Pharmakologie, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20246 , Hamburg, Germany

    M. Flato, S. Albers & S. Laer

  3. Zentrum für Klinisch-Theoretische Medizin I, Institut für Klinische Chemie, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20246 , Hamburg, Germany

    M. Haddad & R. Budden

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  1. T.S. Mir
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  2. M. Flato
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  3. J. Falkenberg
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  4. M. Haddad
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  6. J. Weil
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  7. S. Albers
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  8. S. Laer
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Correspondence to T.S. Mir.

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Mir, T., Flato, M., Falkenberg, J. et al. Plasma Concentrations of N-Terminal Brain Natriuretic Peptide in Healthy Children, Adolescents, and Young Adults: Effect of Age and Gender. Pediatr Cardiol 27, 73–77 (2006). https://doi.org/10.1007/s00246-005-1022-4

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  • DOI: https://doi.org/10.1007/s00246-005-1022-4

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