Concentrations of brain natriuretic peptide in the plasma predicts outcomes of treatment of children with decompensated heart failure admitted to the Intensive Care unit

Lin Hua Tan, John Jefferies, Jian Feng Liang, Susan W. Denfield, William J. Dreyer, Antonio R. Mott, Michelle A. Grenier, Heather A. Dickerson, Jack F. Price, Jeffrey Towbin, Ching Nan Ou, Anthony C. Chang

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Objectives: It is known that levels of brain natriuretic peptide predict outcomes of treatment for adults with decompensated heart failure.We hypothesized that it could predict outcomes in children with this condition. Methods: We divided retrospectively 82 patients with serial measurements of brain natriuretic peptide into 3 groups: those who survived and did not need readmission within less than 60 days; those who survived but needed readmission within less than 60 days; and those who died in hospital or within less than 60 days. Initial and final levels of the peptide correlated with adverse outcomes. Results: The percent change in level of the peptide was minus 78 percent, minus 38 percent, and 138 percent in the readmission-free group, the readmitted, and nonsurviving groups, respectively. Final levels were significantly lower in the readmission-free group than in the readmitted and nonsurviving groups (p equals 0.013 and p is less than 0.00001, respectively) and in the readmitted group than in the nonsurvivors (p equals 0.013). On univariate analysis, the final level, the change in level, and the percentage change in level significantly predicted outcomes (p equals 0.0002, 0.0072 and 0.0005, respectively). On multivariate analysis, only the final level of the peptide significantly predicted outcomes (p equals 0.01). Conclusions: A final level of brain natriuretic peptide of greater than or equal to 760 picograms per millilitre strongly predicted an adverse outcome. Patients with higher final levels may be at higher risk of death and readmission, suggesting that this variable effectively predicts the response to treatment and prognosis in children with heart failure.

Original languageEnglish (US)
Pages (from-to)397-406
Number of pages10
JournalCardiology in the young
Volume17
Issue number4
DOIs
StatePublished - Aug 1 2007

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Brain Natriuretic Peptide
Intensive Care Units
Heart Failure
Peptides
Multivariate Analysis
Therapeutics

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine

Cite this

Concentrations of brain natriuretic peptide in the plasma predicts outcomes of treatment of children with decompensated heart failure admitted to the Intensive Care unit. / Tan, Lin Hua; Jefferies, John; Liang, Jian Feng; Denfield, Susan W.; Dreyer, William J.; Mott, Antonio R.; Grenier, Michelle A.; Dickerson, Heather A.; Price, Jack F.; Towbin, Jeffrey; Ou, Ching Nan; Chang, Anthony C.

In: Cardiology in the young, Vol. 17, No. 4, 01.08.2007, p. 397-406.

Research output: Contribution to journalArticle

Tan, Lin Hua ; Jefferies, John ; Liang, Jian Feng ; Denfield, Susan W. ; Dreyer, William J. ; Mott, Antonio R. ; Grenier, Michelle A. ; Dickerson, Heather A. ; Price, Jack F. ; Towbin, Jeffrey ; Ou, Ching Nan ; Chang, Anthony C. / Concentrations of brain natriuretic peptide in the plasma predicts outcomes of treatment of children with decompensated heart failure admitted to the Intensive Care unit. In: Cardiology in the young. 2007 ; Vol. 17, No. 4. pp. 397-406.
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title = "Concentrations of brain natriuretic peptide in the plasma predicts outcomes of treatment of children with decompensated heart failure admitted to the Intensive Care unit",
abstract = "Objectives: It is known that levels of brain natriuretic peptide predict outcomes of treatment for adults with decompensated heart failure.We hypothesized that it could predict outcomes in children with this condition. Methods: We divided retrospectively 82 patients with serial measurements of brain natriuretic peptide into 3 groups: those who survived and did not need readmission within less than 60 days; those who survived but needed readmission within less than 60 days; and those who died in hospital or within less than 60 days. Initial and final levels of the peptide correlated with adverse outcomes. Results: The percent change in level of the peptide was minus 78 percent, minus 38 percent, and 138 percent in the readmission-free group, the readmitted, and nonsurviving groups, respectively. Final levels were significantly lower in the readmission-free group than in the readmitted and nonsurviving groups (p equals 0.013 and p is less than 0.00001, respectively) and in the readmitted group than in the nonsurvivors (p equals 0.013). On univariate analysis, the final level, the change in level, and the percentage change in level significantly predicted outcomes (p equals 0.0002, 0.0072 and 0.0005, respectively). On multivariate analysis, only the final level of the peptide significantly predicted outcomes (p equals 0.01). Conclusions: A final level of brain natriuretic peptide of greater than or equal to 760 picograms per millilitre strongly predicted an adverse outcome. Patients with higher final levels may be at higher risk of death and readmission, suggesting that this variable effectively predicts the response to treatment and prognosis in children with heart failure.",
author = "Tan, {Lin Hua} and John Jefferies and Liang, {Jian Feng} and Denfield, {Susan W.} and Dreyer, {William J.} and Mott, {Antonio R.} and Grenier, {Michelle A.} and Dickerson, {Heather A.} and Price, {Jack F.} and Jeffrey Towbin and Ou, {Ching Nan} and Chang, {Anthony C.}",
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T1 - Concentrations of brain natriuretic peptide in the plasma predicts outcomes of treatment of children with decompensated heart failure admitted to the Intensive Care unit

AU - Tan, Lin Hua

AU - Jefferies, John

AU - Liang, Jian Feng

AU - Denfield, Susan W.

AU - Dreyer, William J.

AU - Mott, Antonio R.

AU - Grenier, Michelle A.

AU - Dickerson, Heather A.

AU - Price, Jack F.

AU - Towbin, Jeffrey

AU - Ou, Ching Nan

AU - Chang, Anthony C.

PY - 2007/8/1

Y1 - 2007/8/1

N2 - Objectives: It is known that levels of brain natriuretic peptide predict outcomes of treatment for adults with decompensated heart failure.We hypothesized that it could predict outcomes in children with this condition. Methods: We divided retrospectively 82 patients with serial measurements of brain natriuretic peptide into 3 groups: those who survived and did not need readmission within less than 60 days; those who survived but needed readmission within less than 60 days; and those who died in hospital or within less than 60 days. Initial and final levels of the peptide correlated with adverse outcomes. Results: The percent change in level of the peptide was minus 78 percent, minus 38 percent, and 138 percent in the readmission-free group, the readmitted, and nonsurviving groups, respectively. Final levels were significantly lower in the readmission-free group than in the readmitted and nonsurviving groups (p equals 0.013 and p is less than 0.00001, respectively) and in the readmitted group than in the nonsurvivors (p equals 0.013). On univariate analysis, the final level, the change in level, and the percentage change in level significantly predicted outcomes (p equals 0.0002, 0.0072 and 0.0005, respectively). On multivariate analysis, only the final level of the peptide significantly predicted outcomes (p equals 0.01). Conclusions: A final level of brain natriuretic peptide of greater than or equal to 760 picograms per millilitre strongly predicted an adverse outcome. Patients with higher final levels may be at higher risk of death and readmission, suggesting that this variable effectively predicts the response to treatment and prognosis in children with heart failure.

AB - Objectives: It is known that levels of brain natriuretic peptide predict outcomes of treatment for adults with decompensated heart failure.We hypothesized that it could predict outcomes in children with this condition. Methods: We divided retrospectively 82 patients with serial measurements of brain natriuretic peptide into 3 groups: those who survived and did not need readmission within less than 60 days; those who survived but needed readmission within less than 60 days; and those who died in hospital or within less than 60 days. Initial and final levels of the peptide correlated with adverse outcomes. Results: The percent change in level of the peptide was minus 78 percent, minus 38 percent, and 138 percent in the readmission-free group, the readmitted, and nonsurviving groups, respectively. Final levels were significantly lower in the readmission-free group than in the readmitted and nonsurviving groups (p equals 0.013 and p is less than 0.00001, respectively) and in the readmitted group than in the nonsurvivors (p equals 0.013). On univariate analysis, the final level, the change in level, and the percentage change in level significantly predicted outcomes (p equals 0.0002, 0.0072 and 0.0005, respectively). On multivariate analysis, only the final level of the peptide significantly predicted outcomes (p equals 0.01). Conclusions: A final level of brain natriuretic peptide of greater than or equal to 760 picograms per millilitre strongly predicted an adverse outcome. Patients with higher final levels may be at higher risk of death and readmission, suggesting that this variable effectively predicts the response to treatment and prognosis in children with heart failure.

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U2 - 10.1017/S1047951107000601

DO - 10.1017/S1047951107000601

M3 - Article

VL - 17

SP - 397

EP - 406

JO - Cardiology in the Young

JF - Cardiology in the Young

SN - 1047-9511

IS - 4

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