Abstract 3037: Clinical and Echocardiographic Correlates of Near Patient B-Type Natriuretic Peptide (BNP) Testing in the Pediatric Heart Failure Clinic
Introduction: Brain Natriuretic Peptide is beginning to be used in pediatric heart failure clinics. We aimed to evaluate the relationship of BNP to conventional clinical and echocardiographic markers in children with left ventricular dysfunction using near patient testing.
Methods: A near patient “Biosite Triage Plus” meter was used to measure BNP in the setting of a pediatric heart failure and transplant service. 47 patients were studied: age range: 3 weeks to 16.5 years; aetiology of left ventricular dysfunction: dilated cardiomyopathy 29, viral myocarditis 6, anthracycline toxicity 4, myocardial ischaemia 4, tachyarrhythmia induced cardiomyopathy 2, mitochondrial disease 1, hypocalcaemia 1. BNP was correlated to parametric data (fractional shortening (FS %), Tissue Doppler velocity (TD)) with Pearson’s correlation coefficient. For non-parametric data (Z-score, NYHA and Ross score) Spearman’s correlation coefficient was used.
Results: Serial BNP followed clinical status (Ross and NYHA) and correlated to p <0.01 (figure⇓). Ross and NYHA improved or stabilised in 28 patients, but in 19 there was worsening heart failure severity, (4 died, 14 transplanted, 1 listed for transplant). Higher BNP levels correlated to lower FS % p <0.01. TD velocities were analysable in 36 cases and higher BNP correlated to lower: mitral lateral Sa (p:0.03), mitral septal Sa (p:0.006), mitral septal Ea (p:0.007).
Conclusions: This is the largest study of BNP in children with impaired left ventricular function, the strong correlation to clinical and echocardiographic status and outcome suggests near patient testing will be a useful addition to the pediatric heart failure clinic.