Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Aug 12;25(16):8781.
doi: 10.3390/ijms25168781.

Clinical Significance of B-Type Natriuretic Peptide and N-Terminal Pro-B-Type Natriuretic Peptide in Pediatric Patients: Insights into Their Utility in the Presence or Absence of Pre-Existing Heart Conditions

Kamila Maria Ludwikowska  1 , Monika Tokarczyk  1 , Bartłomiej Paleczny  2 , Paweł Tracewski  3 , Leszek Szenborn  1 , Jacek Kusa  3   4
Affiliations
Review

Clinical Significance of B-Type Natriuretic Peptide and N-Terminal Pro-B-Type Natriuretic Peptide in Pediatric Patients: Insights into Their Utility in the Presence or Absence of Pre-Existing Heart Conditions

Kamila Maria Ludwikowska et al. Int J Mol Sci. .

Abstract

The clinical significance of B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in pediatric patients remains an area of evolving understanding, particularly regarding their utility in the presence or absence of pre-existing heart conditions. While clear cutoff values and established roles in heart failure are understood in adult patients, pediatric norms vary with age, complicating interpretation. Notably, the emergence of multi-system inflammatory syndrome in children (MIS-C) has highlighted the importance of these markers not only in the detection of acute heart failure but also as a marker of disease severity and even as a differential diagnosis tool. This review summarizes current knowledge on the utility of BNP and NT-proBNP in pediatric patients. Their unique physiology, including circulation and compensation mechanisms, likely influence BNP and NT-proBNP release, potentially even in non-heart failure states. Factors such as dynamic volemic changes accompanying inflammatory diseases in children may contribute. Thus, understanding the nuanced roles of BNP and NT-proBNP in pediatric populations is crucial for the accurate diagnosis, management, and differentiation of cardiac and non-cardiac conditions.

Keywords: BNP; Kawasaki disease; MIS-C; children; heart failure.

PubMed Disclaimer

Conflict of interest statement

K.M.L., B.P., and L.S. are employees of Wroclaw Medical University. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Physiology of BNP and NT-proBNP production.
See this image and copyright information in PMC

References

    1. Mueller C., McDonald K., de Boer R.A., Maisel A., Cleland J.G.F., Kozhuharov N., Coats A.J.S., Metra M., Mebazaa A., Ruschitzka F., et al. Heart Failure Association of the European Society of Cardiology practical guidance on the use of natriuretic peptide concentrations. Eur. J. Heart Fail. 2019;21:715–731. doi: 10.1002/ejhf.1494. - DOI - PubMed
    1. de Bold A.J., Borenstein H.B., Veress A.T., Sonnenberg H. A rapid and potent natriuretic response to intravenous injection of atrial myocardial extract in rats. Life Sci. 1981;28:89–94. doi: 10.1016/0024-3205(81)90370-2. - DOI - PubMed
    1. Goetze J.P., Bruneau B.G., Ramos H.R., Ogawa T., de Bold M.K., de Bold A.J. Cardiac natriuretic peptides. Nat. Rev. Cardiol. 2020;17:698–717. doi: 10.1038/s41569-020-0381-0. - DOI - PubMed
    1. Sarzani R., Allevi M., Di Pentima C., Schiavi P., Spannella F., Giulietti F. Role of Cardiac Natriuretic Peptides in Heart Structure and Function. Int. J. Mol. Sci. 2022;23:14415. doi: 10.3390/ijms232214415. - DOI - PMC - PubMed
    1. Nakagawa H., Saito Y. Roles of Natriuretic Peptides and the Significance of Neprilysin in Cardiovascular Diseases. Biology. 2022;11:1017. doi: 10.3390/biology11071017. - DOI - PMC - PubMed

MeSH terms

LinkOut - more resources