Usefulness of Plasma B-type Natriuretic Peptide Assay as a Screening Tool for Infants with Suspected Congenital Heart Disease

ABSTRACT

PURPOSE: B-type natriuretic peptide (BNP) is a cardiac neurohormone secreted predominantly from the ventricle in response to increased left and right ventricular pressure loads as well as volume loads. The aim of our study is to investigate the usefulness of plasma BNP assay as a screening tool for infants with suspected congenital heart disease (CHD). METHODS: Ninety-five infants less than 3 months of age with suspected CHD were enrolled and divided into a healthy control group (n=40) and a CHD group (n=50) according to physical examination, chest X-ray, electrocardiography and echocardiography. The CHD group was divided into the treatment group (n=15), requiring urgent treatment and the observation group (n=35), not requiring any treatment. Plasma BNP concentrations were measured using a commercial kit, Triage BNP(R) test kit. RESULTS: The mean BNP concentration of the CHD group was higher than that of the control group (639+/-1, 147 pg/mL versus 26+/-25 pg/mL, P<0.001). The mean BNP concentration of the treatment group was significantly higher than that of the observation group (1, 732+/-1, 629 pg/mL versus 171+/-229 pg/mL, P<0.001). The area under the Receiver Operating Characteristic curve for the detection of CHD was high 0.821 (95% CI, 0.737-0.905, P<0.001). The best cut-off value of BNP concentration for the screening of CHD requiring urgent treatment was determined to be 282 pg/mL (sensitivity 100%, negative predictive value 100%). CONCLUSION: In infants, the plasma BNP measurement is useful and objective in screening the CHD infant without any specific professional skills. Especially in the outpatient department, it is very helpful to determine CHD infant requiring urgent treatment and thus an efficient consultation can be made to the pediatric cardiologist.