TY - JOUR
T1 - Comparison between BNP and NT-proBNP in pediatric populations
AU - Tawiah, Kwaku D.
AU - Franks, Caroline E.
AU - Tang, Jessica
AU - Gazit, Avihu
AU - Dietzen, Dennis J.
AU - Farnsworth, Christopher W.
N1 - Publisher Copyright:
© 2022 The Canadian Society of Clinical Chemists
PY - 2022/11/1
Y1 - 2022/11/1
N2 - Background: B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) are essential biomarkers for the evaluation of cardiac pathologies. However, pediatric reference intervals for BNP and NT-proBNP are not well defined and concordance between them in the evaluation of pediatric patients has been poorly described. Methods: Paired BNP and NT-proBNP testing was performed on 311 specimens representing 175 pediatric patients. Pediatric BNP and NT-proBNP reference intervals derived from the literature were used to evaluate concordance of results based on age group and cardiac pathology. Results: Deming regression analysis of BNP and NT-proBNP results revealed a slope of 13.63 (95% CI, 10.35–16.92) and y-intercept of −977.8 (-2063–107.2) with a positive Spearman correlation (r = 0.91). By age group, concordance kappa between BNP and NT-proBNP was 1.0 for 0–10 days, 0.23 (0–0.62) for 11–30 days, 0.82 (0.67–0.97) for 31 days–1 year, 0.81 (0.57–1.0) for 1–2 years and 0.73 (0.64–0.86) for 2–18 years. The ratio of NT-proBNP to BNP was lowest in heart transplant patients (ratio, 6.5 [95% CI, 5.1–8.1]) relative to those with heart disease (10.5 [8.8–13.7]) and pulmonary hypertension (14.2 [11.3–16.0]) but no differences in concordance were observed. For serial specimens, 21% displayed inverse, discordant changes in BNP and NT-proBNP results. Review of discordant serial results revealed that kinetics of changes was comparable and unlikely to be clinically significant. Conclusions: There is positive correlation and moderate concordance between BNP and NT-proBNP in the pediatric population studied.
AB - Background: B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) are essential biomarkers for the evaluation of cardiac pathologies. However, pediatric reference intervals for BNP and NT-proBNP are not well defined and concordance between them in the evaluation of pediatric patients has been poorly described. Methods: Paired BNP and NT-proBNP testing was performed on 311 specimens representing 175 pediatric patients. Pediatric BNP and NT-proBNP reference intervals derived from the literature were used to evaluate concordance of results based on age group and cardiac pathology. Results: Deming regression analysis of BNP and NT-proBNP results revealed a slope of 13.63 (95% CI, 10.35–16.92) and y-intercept of −977.8 (-2063–107.2) with a positive Spearman correlation (r = 0.91). By age group, concordance kappa between BNP and NT-proBNP was 1.0 for 0–10 days, 0.23 (0–0.62) for 11–30 days, 0.82 (0.67–0.97) for 31 days–1 year, 0.81 (0.57–1.0) for 1–2 years and 0.73 (0.64–0.86) for 2–18 years. The ratio of NT-proBNP to BNP was lowest in heart transplant patients (ratio, 6.5 [95% CI, 5.1–8.1]) relative to those with heart disease (10.5 [8.8–13.7]) and pulmonary hypertension (14.2 [11.3–16.0]) but no differences in concordance were observed. For serial specimens, 21% displayed inverse, discordant changes in BNP and NT-proBNP results. Review of discordant serial results revealed that kinetics of changes was comparable and unlikely to be clinically significant. Conclusions: There is positive correlation and moderate concordance between BNP and NT-proBNP in the pediatric population studied.
UR - http://www.scopus.com/inward/record.url?scp=85135555247&partnerID=8YFLogxK
U2 - 10.1016/j.clinbiochem.2022.08.003
DO - 10.1016/j.clinbiochem.2022.08.003
M3 - Article
C2 - 35940296
AN - SCOPUS:85135555247
SN - 0009-9120
VL - 109-110
SP - 74
EP - 78
JO - Clinical Biochemistry
JF - Clinical Biochemistry
ER -