Key result
A plasma NT-proBNP level of ≥598 ng/l combined with a modified Ross criteria score of ≥4 is highly diagnostic of pediatric heart failure.
Why the study?
Does the combination of NT-proBNP level and modified Ross criteria score improve the diagnosis of pediatric heart failure?
Case-Control (n=240)
No
Does the combination of NT-proBNP level and modified Ross criteria score improve the diagnosis of pediatric heart failure?
Effect estimate: AUC 0.979 (95% CI 0.948-0.994)
A plasma NT-proBNP level of ≥598 ng/l combined with a modified Ross criteria score of ≥4 provides high diagnostic accuracy for pediatric heart failure.
May aid pediatric HF diagnosis; hypothesis-generating and requires prospective validation.
The aim of this study was to investigate the modified Ross criteria score and the diagnostic cut-off level for plasmatic amino-terminal pro-brain natriuretic peptide (NT-proBNP) in the diagnosis of pediatric heart failure, by analyzing the receiver operating characteristic (ROC) curve. The plasma NT-proBNP level was measured in 80 children diagnosed with heart failure according to the modified Ross criteria, 80 children with non-cardiogenic dyspnea and 80 healthy children. The NT-proBNP levels were then compared using an F-test. The cut-off score for heart failure in the modified Ross criteria and the diagnostic cut-off level for plasmatic NT-proBNP in pediatric heart failure were determined by ROC curve analysis. The results demonstrated that the NT-proBNP level was markedly increased in 76 of the 80 children with heart failure, and the correlation with the modified Ross criteria was 95%. Based on ROC curve analysis, the diagnosis of pediatric heart failure was most accurate when the modified Ross criteria score was ≥4 and the plasmatic NT-proBNP level was ≥598 ng/l. The NT-proBNP level was normal (0-300 ng/l) in the children with non-cardiogenic dyspnea and the healthy children. Significant differences were observed in the comparison of the three groups (P<0.01). In conclusion, a NT-proBNP level of ≥598 ng/l, combined with a modified Ross criteria score ≥4, is highly diagnostic of heart failure in children.
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Lin et al. (2013) conducted a case-control in Pediatric heart failure (n=240). Plasma NT-proBNP level and modified Ross criteria vs. Non-cardiogenic dyspnea and healthy children was evaluated on Diagnostic accuracy (AUC) of plasma NT-proBNP level for pediatric heart failure (AUC 0.979, 95% CI 0.948-0.994). A plasma NT-proBNP level of ≥598 ng/l combined with a modified Ross criteria score of ≥4 is highly diagnostic of pediatric heart failure.
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