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Meta-Analysis
. 2024 Dec;56(1):2352603.
doi: 10.1080/07853890.2024.2352603. Epub 2024 May 16.

Accuracy of brain natriuretic peptide and N-terminal brain natriuretic peptide for detecting paediatric pulmonary hypertension: a systematic review and meta-analysis

Ruixi Zhou  1 , Yupeng Lei  1 , Long Ge  2   3 , Qian Mao  1 , Liuping Yang  1 , Xia Qiu  1
Affiliations
Meta-Analysis

Accuracy of brain natriuretic peptide and N-terminal brain natriuretic peptide for detecting paediatric pulmonary hypertension: a systematic review and meta-analysis

Ruixi Zhou et al. Ann Med. 2024 Dec.

Abstract

Objective: Pulmonary hypertension (PH) is a life-threatening disease, especially in paediatric population. Symptoms of paediatric PH are non-specific. Accurate detection of paediatric PH is helpful for early treatment and mortality reduction. Therefore, we assessed the overall performance of brain natriuretic peptide (BNP) and N-terminal brain natriuretic peptide (NT-proBNP) for diagnosing PH in paediatric population.

Methods: PubMed, Web of Science, Cochrane Library and Embase databases were screened since their respective inceptions until August 2023. A bivariate random model and a hierarchical summary receiver operating characteristic model were used together to evaluate and summarize the overall performance of BNP and NT-proBNP for diagnosing paediatric PH.

Results: Eighteen studies using BNP/NT-proBNP were assessed, comprising 1127 samples. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and area under the curve (AUROC) of BNP/NT-proBNP were separately as 0.81, 0.87, 6.33, 0.21, 29.50 and 0.91, suggesting a good diagnostic performance of BNP/NT-proBNP for detecting PH in paediatric population. For BNP, the pooled sensitivity, specificity, PLR, NLR, DOR and AUROC were 0.83, 0.89, 7.76, 0.19, 40.90 and 0.93, indicating the diagnostic accuracy of BNP for paediatric PH patients was good. For NT-proBNP, the pooled sensitivity, specificity, PLR, NLR, DOR and AUROC were 0.81, 0.86, 5.59, 0.22, 24.96 and 0.90, showing that NT-proBNP could provide a good value for detecting paediatric PH.

Conclusions: Both BNP and NT-proBNP are good markers for differentiating paediatric PH patients from non-PH individuals.

Keywords: N-terminal brain natriuretic peptide; Pulmonary hypertension; brain natriuretic peptide; paediatric; sensitivity; specificity.

Plain language summary

Accurate detection of paediatric PH is helpful for early treatment and mortality reduction. This study shows that both BNP and NT-proBNP are good markers for detecting paediatric PH. In clinical practice, we recommend that BNP and NT-proBNP are auxiliary biomarkers in diagnosing paediatric PH.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
The selection process of included studies.
Figure 2.
Figure 2.
Quality for the included articles.
Figure 3.
Figure 3.
Hierarchical summary receiver operating characteristic plot to summarize diagnostic performance of BNP/NT-proBNP for detecting paediatric PH.
Figure 4.
Figure 4.
Hierarchical summary receiver operating characteristic plot to summarize diagnostic performance of BNP for detecting paediatric PH.
Figure 5.
Figure 5.
Hierarchical summary receiver operating characteristic plot to summarize diagnostic performance of NT-proBNP for detecting paediatric PH.
See this image and copyright information in PMC

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