M17. The usefulness of brain natriuretic peptide measurement in pediatric patients with cardiovascular disease: a systematic review and meta-analysis

Abstract

Background and Aims The use of brain natriuretic peptide (BNP), a common cardiac biomarker, has traditionally been limited to adult populations for heart failure assessment. In children, less is known about the diagnostic value of BNP. Emerging evidence suggests they might be useful in diagnosis of children with cardiovascular disease. We aim to evaluate the use of BNP in children with cardiovascular disease. Methods and Results We performed a systematic review of literatures on online databases for studies evaluating level of BNP in children with cardiovascular disease from inception to July 26, 2021. A total number of 8 studies comprising 1304 patients were included in the meta-analysis. All articles included in the meta-analysis had high quality according to the GRADE approach. From our analysis, higher BNP was found in patients with congenital heart disease (CHD) compared with healthy subjects (SMD 2.88 [0.21-5.56], p = 0.03; I2 99%). Higher BNP was also found in children with heart failure (HF) compared with patients without HF (SMD 1.21 [0.73-1.69], p < 0.0001; I2 0%), and higher in CHD patients with pulmonary hypertension (PH) compared with CHD patients without PH (SMD 1.76 [0.02-3.51], p = 0.05; I2 95%). Conclusion Significantly higher level of BNP was found in CHD patients, CHD-PH, and HF patients. Therefore, BNP measurement might be used for screening of CHD, PH in CHD populations and HF in pediatric populations. Further study is required to determine diagnostic accuracies and cut-offs within age groups.