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

• Published in: International journal of molecular sciences 2024-08, Vol.25 (16), p.8781
• Main Authors: Ludwikowska, Kamila Maria, Tokarczyk, Monika, Paleczny, Bartłomiej, Tracewski, Paweł, Szenborn, Leszek, Kusa, Jacek
• Format: Article
• Language: English
• Subjects: Adrenal glands; Antiarrhythmics; Biomarkers; Biomarkers - blood; Biosynthesis; Blood pressure; Blood vessels; BNP; Body fat; Cardiac arrhythmia; Cardiac function; Child; children; Clinical Relevance; Coronaviruses; COVID-19; Heart Diseases - blood; Heart Diseases - diagnosis; Heart Diseases - metabolism; Heart failure; Heart Failure - blood; Heart Failure - diagnosis; Heart Failure - metabolism; Homeostasis; Humans; Hypertension; Inflammation; Kawasaki disease; MIS-C; Natriuretic Peptide, Brain - blood; Natriuretic Peptide, Brain - metabolism; Pediatrics; Peptide Fragments - blood; Peptides; Permeability; Physiology; Plasma; Review; Sepsis; Smooth muscle; Systemic Inflammatory Response Syndrome - blood; Systemic Inflammatory Response Syndrome - diagnosis
• ISSN: 1661-6596; 1422-0067; 1422-0067
• DOI: 10.3390/ijms25168781

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.