Pulmonary hypertension (PH) is a life-threatening disease with a high mortality rate and a broad variety of underlying etiologies. The current golden standard for diagnosing PH and monitoring efficiency of treatment is right heart catheterization. As an alternative, serum biomarkers have been suggested. Cardiac troponin T (TnT), brain natriuretic peptide (BNP), and NT-proBNP seem the most potential. The aim of this systematic review was to evaluate the current literature on the prognostic value of these biomarkers in children with PH and their usefulness as a diagnostic tool. A systematic literature search yielded 14 studies on patients ≤18 years with proven PH with (NT-pro)BNP or TnT as primary outcome. TnT is suggested to be a promising biomarker, but its usefulness in clinical practice has not been proven. The levels of (NT-pro)BNP seemed to be reliable within one PH category, but differed significantly between categories. NT-proBNP showed a good correlation with mortality and might have a prognostic value. Conclusion: The lack of absolute levels makes (NT-pro)BNP unsuitable as a diagnostic marker, but in view of the relative changes, it could be used to monitor patients. Further investigation should explore differences in normal (NT-pro)BNP levels between the different categories of PH.

Biological markers, Natriuretic peptide, Pulmonary hypertension, Troponin
dx.doi.org/10.1007/s00431-015-2619-0, hdl.handle.net/1765/81311
European Journal of Pediatrics
Department of Intensive Care

ten Kate, C.A, Tibboel, D, & Kraemer, U. (2015). B-type natriuretic peptide as a parameter for pulmonary hypertension in children. A systematic review. European Journal of Pediatrics (Vol. 174, pp. 1267–1275). doi:10.1007/s00431-015-2619-0