Amino-terminal pro-brain-type natriuretic peptide: Heart or lung disease in pediatric respiratory distress?

Objectives. The aim of this study was to determine whether plasma levels of amino-terminal pro-brain natriuretic peptide (N-BNP) could differentiate between heart failure and lung disease among infants with acute respiratory distress. In addition, our aim was to determine whether plasma levels of N-BNP could be used to monitor the effects of treatment among infants with heart failure. Methods. Infants ( age range: 1 - 36 months; median age: 10 months) who presented with respiratory distress underwent physical examination, plasma N-BNP measurement, and echocardiography within 24 hours after admission. Seventeen infants were finally diagnosed with acute heart failure and 18 with acute lung disease. Thirteen healthy infants served as a control group. Results. Plasma N-BNP levels were significantly higher for the infants with heart failure ( median: 18 452 pg/mL; range: 5375 - 99 700 pg/mL) than for the infants with lung disease ( median: 311 pg/mL; range: 76 - 1341 pg/mL). Among the infants with heart failure, there was a significant difference in plasma N-BNP levels before and after congestive heart failure treatment. Conclusion. Among infants with respiratory distress, plasma N-BNP measurements can differentiate between acute heart failure and lung disease and can be used to monitor the effects of treatment for infants with heart failure.