Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-13T01:06:40.171Z Has data issue: false hasContentIssue false
  • English
  • Français

Release of N-terminal pro-brain natriuretic peptide in children with acute rheumatic carditis

Published online by Cambridge University Press:  26 April 2010

Ömer Çimen ,
Bülent Oran ,
Derya Çimen ,
Tamer Baysal ,
Sevim Karaaslan ,
Ekrem Ünal ,
Kemal Başarılı  and
Sadık Büyükbaş
Ömer Çimen
Affiliation:
Meram Medical Faculty, Department of Paediatrics, Selçuk University, Konya, Turkey
Bülent Oran*
Affiliation:
Selçuklu Medical Faculty, Department of Paediatrics, Selçuk University, Konya, Turkey
Derya Çimen
Affiliation:
Meram Medical Faculty, Department of Paediatrics, Selçuk University, Konya, Turkey
Tamer Baysal
Affiliation:
Meram Medical Faculty, Department of Paediatrics, Selçuk University, Konya, Turkey
Sevim Karaaslan
Affiliation:
Meram Medical Faculty, Department of Paediatrics, Selçuk University, Konya, Turkey
Ekrem Ünal
Affiliation:
Meram Medical Faculty, Department of Paediatrics, Selçuk University, Konya, Turkey
Kemal Başarılı
Affiliation:
Department of Biochemistry, Selçuk University, Konya, Turkey
Sadık Büyükbaş
Affiliation:
Department of Biochemistry, Selçuk University, Konya, Turkey
*
Correspondence to: B. Oran, MD, Professor of Paediatrics, Paediatric Cardiologist, Section of Paediatric Cardiology, Department of Paediatrics, Selçuk University, 42250-Konya, Turkey. Tel: +90 332 3242031; Fax: +90 332 2236181; E-mail: [email protected] and [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Acute rheumatic carditis is still an important cause of cardiac failure in developing countries. B-type natriuretic peptides, especially N-terminal segment of its prohormone are now recognised as essential parts of cardiologic evaluation. Increased plasma concentrations of B-type natriuretic peptide and its prohormone are markers of cardiac failure and hypoxia in adults.

Aim

To measure the prohormone levels in children with acute rheumatic carditis and to determine whether its concentrations correlate with clinical and laboratory findings.

Methods

A total of 24 children with acute rheumatic carditis and 23 age and sex-matched healthy subjects were entered in the study. Transthoracic echocardiography was performed in all patients to assess the severity of the valve insufficiency and cardiac dysfunction. The prohormone plasma levels were tested for correlation with cardiac dysfunction and other biochemical markers, such as C-reactive protein, erythrocyte sedimentation rate, and anti-streptolysin-O titter.

Results

The prohormone plasma concentrations were significantly higher in children with acute rheumatic carditis than in control subjects at the time of diagnosis. A significant decrease of the plasma level was detected among patients after treatments (6–8 weeks).

Conclusion

We found increased plasma prohormone levels in children with acute rheumatic carditis in the acute stage of illness compared with healthy subjects. Another result is increased plasma prohormone levels as acute rheumatic carditis are reversible.

Keywords

N-terminal pro-B-type natriuretic peptideacute rheumatic carditischildhood
Type
Original Articles
Information
Cardiology in the Young , Volume 20 , Issue 3 , June 2010 , pp. 297 - 301
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Nir, A, Nasser, N. Clinical value of NT-ProBNP and BNP in pediatric cardiology. J Card Fail 2005; 11: 76–80.CrossRefGoogle ScholarPubMed
2. Mukoyama, M, Nakao, K, Morii, N, et al. Brain natriuretic peptide as a novel cardiac hormone in humans: evidence for an exquisite dual natriuretic peptide system, atrial natriuteric peptide and brain natriuretic peptide. J Clin Invest 1991; 87: 1402.CrossRefGoogle Scholar
3. Yoshimura, M, Yasue, H, Morita, E, et al. Hemodynamic, renal, and hormonal responses to brain natriuretic peptide infusion in patients with congestive heart failure. Circulation 1991; 84: 1581–1588.CrossRefGoogle ScholarPubMed
4. Nishikimi, T, Yoshihara, F, Morimoto, A, et al. Relationship between left ventricular geometry and natriuretic peptide levels in essential hypertension. Hypertension 1996; 28: 22–30.CrossRefGoogle ScholarPubMed
5. Raizada, V, Williams, RC, Chopra, P, et al. Tissue distribution of lymphocytes in rheumatic heart valves as defined by monoclonal anti-T cell antibodies. Am J Med 1983; 74: 90–98.CrossRefGoogle ScholarPubMed
6. Narula, J, Chopra, P, Talwar, KK, et al. Does endomyocardial biopsy aid in the diagnosis of active rheumatic carditis? Circulation 1993; 88: 2198–2205.CrossRefGoogle ScholarPubMed
7. Chopra, P, Narula, J, Kumar, AS, Sachdeva, S, Bhatia, ML. Immunohistochemical characterization of Aschoff nodules and endomyocardial inflammatory infiltrates in left atrial appendages from patients with chronic rheumatic heart disease. Int J Cardiol 1988; 20: 99–105.CrossRefGoogle ScholarPubMed
8. Tissières, P, da Cruz, E, Habre, W, et al. Value of brain natriuretic peptide in the perioperative follow-up of children with valvular disease. Intensive Care Med 2008; 34: 1109–1113.CrossRefGoogle ScholarPubMed
9. Bayram, E, Kocatürk, H, Yücel, O, Atalay, C, Çolak, MC, Ateşal, S. The role of adrenomedullin and brain natriuretic peptide levels in acute rheumatic fever in adults. Anadolu Cardiol Derg 2008; 8: 188–191.Google ScholarPubMed
10. Diagnosis of Rheumatic Fever-Special Writing Group. Guidelines for the diagnosis of rheumatic fever Jones criteria, 1992 update. JAMA 1992; 268: 2069–2073.CrossRefGoogle Scholar
11. Sahn, DJ, DeMaria, A, Kisslo, J, Weyman, A. The committee in M-mode standardization of the American Society of Echocardiography. Recommendations regarding quantitation in M-mode echocardiography: result of a survey of echocardiographic measurements. Circulation 1978; 58: 1072–1083.CrossRefGoogle Scholar
12. Feigenbaum, H. Echocardiography. Lea & Febiger, Philadelphia, 1994, pp 658–675.Google Scholar
13. Duchak, JM, Chang, SJ, Feigenbaum, H. The posterior mitral valve echo and the echocardiographic diagnosis of mitral stenosis. Am J Cardiol 1972; 29: 628–632.CrossRefGoogle ScholarPubMed
14. Karaaslan, S, Demirören, S, Oran, B, Baysal, T, Başpınar, O, Uçar, C. Criteria for judging the improvement in subclinical rheumatic valvitis. Cardiol Young 2003; 13: 500–505.CrossRefGoogle ScholarPubMed
15. Smith, MD. Evaluation of valvular regurgitation by Doppler echocardiography. Cardiol Clin 1991; 9: 193–228.CrossRefGoogle ScholarPubMed
16. Virmani, R, Roberts, WC. Aschoff bodies in operatively excised atrial appendages and in papillary muscles. Frequency and clinical significance. Circulation 1977; 55: 559–563.CrossRefGoogle ScholarPubMed
17. Campbell, DJ. Can measurement of B-type natriuretic peptide levels improve cardiovascular disease prevention? Clin Exp Pharmacol Physiol 2008; 35: 442–446.CrossRefGoogle ScholarPubMed
18. Morita, E, Yasue, H, Yoshimura, M, et al. Increased plasma levels of brain natriuretic peptide in patients with acute myocardial infarction. Circulation 1993; 88: 82–91.CrossRefGoogle ScholarPubMed
19. Vesely, DL, de Bold, AJ. Cardiac natriuretic peptides gene expression and secretion in inflammation. J Investig Med 2009; 57: 29–32.CrossRefGoogle Scholar
20. Ogawa, T, Veinot, JP, Mercedes, L, Bold, K, Georgalis, T, Bold, AJ. Angiotensin II receptor antagonism reverts the selective cardiac BNP upregulation and secretion observed in myocarditis. Am J Physiol Heart Circ Physiol 2008; 294: H2596–H2603.CrossRefGoogle ScholarPubMed
21. Kemeny, E, Grieve, T, Marcus, R, Sareli, P, Zabriskie, JB. Identification of mononuclear cells and T cell subsets in rheumatic valvulitis. Clin Immunol Immunopathol 1989; 52: 225–237.CrossRefGoogle Scholar
22. Kumar, V, Ganguly, NK, Anand, IS, Wahi, PL. Release of oxygen free radicals by macrophages and neutrophils in patients with rheumatic fever. Eur Heart J 1991; 12: 163–165.CrossRefGoogle ScholarPubMed
23. Kumar, V, Ganguly, NK, Sethi, AK, Anand, IS, Verma, J, Wahi, P. Role of oxygen free radicals generated by blood monocytes and neutrophils in the pathogenesis of rheumatic fever and rheumatic heart disease. J Mol Cell Cardiol 1990; 22: 645–651.CrossRefGoogle ScholarPubMed
24. Oran, B, Atabek, E, Karaaslan, S, Reisli, İ, Gültekin, F, Erkul, İ. Oxygen free radicals in children with acute rheumatic fever. Cardiol Young 2001; 11: 285–288.CrossRefGoogle ScholarPubMed
25. Oran, B, Çoban, H, Karaaslan, S, Atabek, E, Gürbilek, M, Erkul, I. Serum cardiac troponin-I in active rheumatic carditis. Indian J Pediatr 2001; 68: 943–944.CrossRefGoogle ScholarPubMed
26. Williams, RV, Minich, LL, Shaddy, RE, Veasy, LG, Tani, LY. Evidence for lack of myocardial injury in children with acute rheumatic carditis. Cardiol Young 2002; 12: 519–523.CrossRefGoogle ScholarPubMed