Objective: We aimed to determine whether NT-proBNP can differentiate cardiac or pulmonary etiologies of dyspnea, if NT-proBNP can be used for evaluating the effect of treatment in heart failure and for predicting severe pulmonary diseases which are complicated with heart failure.
Methods: Seventy-six children with dyspnea between 1 month-17.5 years old were enrolled. Forty-one of them had heart failure (25 caused by heart disease, 16 caused by pulmonary disease) and 35 had dyspnea due to pulmonary disease. Control group consisted of 32 healthy children. Ross scoring was made, serum NT-proBNP levels were analyzed and left ventricular systolic functions were evaluated by echocardiography.
Results: Serum NT-proBNP levels were significantly higher in children with heart failure than those with pulmonary disease and controls (median 7,321pg/ml, 241 pg/ml, 87.71 pg/ml, respectively), were higher in children with heart failure due to pulmonary diseases than those with pulmonary diseases (2,728 pg/ml, 241 pg/ml, respectively), and were higher in children who died from heart failure than the survivors (p<0.05). After treatment of heart failure, serum NT-proBNP levels significantly decreased (p<0.001). The cutoff level of NT-proBNP for differentiating heart failure from pulmonary disease was 726.8 pg/ml (sensitivity 100%, specificity 94.3%). NT-proBNP levels didn’t correlate with left ventricular systolic functions or Ross scores.
Conclusions: Serum NT-proBNP levels can differentiate dyspnea due to heart failure from pulmonary diseases. It can also be used to monitor the effects of treatment of heart failure and to estimate the prognosis, and for predicting pulmonary diseases which are complicated with heart failure.