N-terminal pro B-type Natriuretic Peptide Levels and Dilated Cardiomyopathy: A Tissue Doppler Echocardiographic Study in Children

Document Type : Original Article


1 Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.

2 Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.

3 Pediatric Department, Medical Faculty, Mashhad University of Medical Sciences (MUMS), Mashhad, IR Iran.


Background: The N-terminal segment of the pro-brain natriuretic peptide (NT-proBNP) has emerged as a marker for heart failure. Dilated cardiomyopathy (DCM) as a major cause of congestive heart failure in children leads to a low cardiac output. However, only a few studies have shown the role of tissue Doppler imaging (TDI) in children with DCM. We sought to explore the associations between TDI parameters and NT-proBNP among DCM patients.
Methods: The present cross-sectional study consecutively enrolled 28 children with DCM. All the patients were on medical therapies in a stable condition upon entrance into the study. All the children were examined by 2D transthoracic echocardiography. TDI imaging was taken from lateral and septal mitral valve areas, and myocardial velocity was calculated by TDI. All the children gave blood samples for the measurement of the NT-proBNP level.
Results: Seventeen patients (60.7%) were female, and the patients’ median age was 10 (IQR25%-75%: 1 to 13) years. The NT-proBNP median was 8614 (IQR25%-75%, 2592 to 20909) pg/mL. There were statistically significant linear relationships between the NT-proBNP level and the lateral myocardial performance index (MPI) (ρ=0.416), the septal MPI (ρ=0.740), the septal E/e´ (ρ=0.533), and the lateral E/e´ (ρ=0.448). The strongest correlation coefficients were observed between the NT-proBNP level and the left ventricular ejection fraction (ρ= −0.754; P=0.001) and the septal MPI (ρ=0.740; P=0.001), even after indexing by body surface area.
Conclusions: NT-proBNP levels correlated strongly with the left ventricular function measured by TDI parameters. Noninvasive echocardiographic evaluations can be implemented to assess children with DCM. (Iranian Heart Journal 2022; 23(1): 54-64)


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