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Practical application of natriuretic peptides in paediatric cardiology

Published online by Cambridge University Press:  11 May 2010

Julie Smith ,
Jens P. Goetze ,
Claus B. Andersen  and
Niels Vejlstrup
Julie Smith
Affiliation:
Department of Pathology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
Jens P. Goetze
Affiliation:
Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
Claus B. Andersen
Affiliation:
Department of Pathology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
Niels Vejlstrup*
Affiliation:
Department of Paediatric Cardiology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
*
Correspondence to: Dr N. Vejlstrup, MD, PhD, Department of Paediatric Cardiology (2011), Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. Tel: +45 3545 0924; Fax: +45 3545 2705; E-mail: niels.vejlstrup@rh.regionh.dk
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Abstract

It is still uncertain if cardiac natriuretic peptides are useful biomarkers in paediatric cardiology. In this review we identify four clinical scenarios in paediatric cardiology, where clinical decision-making can be difficult, and where we feel the paediatric cardiologists need additional diagnostic tools. Natriuretic peptide measurements could be that extra tool. We discuss and suggest N-terminal pro-B-type natriuretic peptide and B-type natriuretic peptide reference intervals for children without cardiovascular disease and cut-off points for the four specific paediatric heart conditions. We conclude that in premature neonates with persistent arterial ducts; in teenagers with tetralogy of Fallot and pulmonary regurgitation; and in children with heart transplants and potential allograft rejection cardiac peptides can provide the clinician with additional information, but in children with atrial septal defects the peptides are not helpful in guiding treatment or follow-up.

Keywords

B-type natriuretic peptideN-terminal pro-B-type natriuretic peptidecongenital cardiac diseaseheart transplantationreference intervals
Type
Reviews
Information
Cardiology in the Young , Volume 20 , Issue 4 , August 2010 , pp. 353 - 363
Copyright
Copyright © Cambridge University Press 2010

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