Role of Brain Natriuretic Peptide in Detection of Right Ventricular Dysfunction and Pulmonary Hypertension among Children with Chronic Lung Diseases

Abstract

Abstract Background: Pulmonary arterial hypertension (PAH) is an important determinant of morbidity, mortality and severity in chronic lung diseases children. Echocardiography is an indirect measure for PH with a limited accuracy compared to right heart catheterization and requires qualified physicians. BNP is the major hormone of the natriuretic peptide system, which is highly activated in different left and right heart diseases in the context of neurohumoral activation. In addition, in pulmonary arterial hypertension, BNP levels are elevated and seem to reflect clinical and hemodynamic status in this patient population. So, the aim of current study to detect the role of BNP in detection of pulmonary hypertension in CLDs children as objective, easy, repeatable available method. Methods: Case-control study on thirty (30) children with Chronic lung diseases who recruited from the Pediatric chest clinic, Children hospital, Ain Shams University. We classified patients into PH and non-PH groups according to echocardiographic measurement of PAP >25mmHg.Serum BNP was assessed and correlated to echocardiographic data. Results: Serum BNP showed a highly statistically significant difference between two groups. AS, mean level of BNP in PH group compared to non-PH group was (265.30±199.83 &40.01±23.01) respectively. Moreover, BNP significantly correlated with Echocardio-graphic parameters that reflect RT ventricular dysfunction. BNP cut-off to diagnose PH among studied patients was > 97.5 pg/ml with sensitivity of 95%, specificity of 98%, PPV equals 98%, NPV equals 94% and accuracy 98%. Conclusion: BNP is an objective, repeatable, easy marker can be used to diagnose pulmonary hypertension in chronic lung diseases in children.