B-Type Natriuretic Peptide in Bronchiolitis: Its Relationship with Left Ventricular Systolic Functions and Prognosis

Abstract

Introduction: We have limited information about the clinicalimportance of plasma B-type natriuretic peptide (BNP) level andits prognostic value in children with bronchiolitis. In this study, weaimed to determine basal plasma BNP levels and their relationshipwith left ventricular systolic functions and prognosis in patientshospitalized with moderate to severe bronchiolitis.Methods: The study was conducted prospectively on 37 patientsaged 1-24 months with a modified Wang respiratory score of 6and above and diagnosed with bronchiolitis. The patients with high(>100 pg/mL, n=6) and normal (?100 pg/mL, n=31) serum BNPlevels were compared in terms of left ventricular systolic functions,and vital, laboratory, and radiological findings. The relationshipbetween serum BNP level and prognosis was evaluated.Results: The mean basal plasma BNP level in the patients wassignificantly higher than in controls (61.75±65 pg/mL vs. 13.99±8.79pg/mL; p=0.001). There was no significant difference in ejectionfraction and fractional shortening values between the patients withnormal and high BNP levels and controls (p>0.05). Patients withhigh BNP levels had higher mean partial carbon dioxide values thanpatients with normal BNP levels (p=0.037). There was a positivecorrelation between plasma BNP level and length of hospital stay(r=0.286; p=0.007) and intensive care unit stay (r=0.645; p=0.000).Conclusion: An increase in serum BNP levels may be seen inpatients with moderate to severe bronchiolitis without myocardialdysfunction. It was argued that this BNP increase may be relatedto the degree of deterioration of gas exchange associated with thedisease. Plasma BNP level is a potential prognostic factor in moderateto severe bronchiolitis.