Objective: Pro-B type brain natriuretic peptide (proBNP) is released from cardiac ventricular myocytes as a result of increased volume and pressure. Troponin T plays a role in the contraction process. Both proteins may be elevated in many cardiac and non-cardiac conditions. Our aim is to evaluate troponin T values and cardiac findings of the patients in pediatric intensive care unit (PICU) with elevated proBNP levels.
Method: Patients with high proBNP values who were admitted to the PICU between January 2022 and January 2023 were included in the study. The clinical diagnoses, proBNP, and troponin T values were recorded. Information about the presence of heart disease and the status of systolic functions were obtained from echocardiographic examination reports.
Results: One hundred and ten patients were included in the study. Mean age of the patients was 2.48±3.41 years. Among the patients hospitalized in the pediatric intensive care unit, 41% had lower respiratory tract infections, and 20% had heart disease. The mean proBNP values were 11827.06±12652.82 ng/l, and troponin T was 201.41±737.74 ng/l. Ejection fraction (EF) was normal in 75% of the patients. The mean values of proBNP and troponin T in the patients with normal EF were 7284.74±8437.16 ng/l and 49.67±73.15 ng/l while the mean values of proBNP and troponin were 25129±13659.24 ng/l and 645.8±1380.74 ng/l in the patients with decreased EF (p<0.05, for both). ProBNP and troponin T values of the patients with decreased EF accompanied with or without heart disease were higher than those in the group with normal EF without existing heart disease (p<0.0001, for all). It was observed that decreased EF value was more common in cases who have proBNP>16314 ng/l and troponin T >114 ng/l (p=0.0031, p<0.0001, respectively).
Conclusion: ProBNP and troponin T values increase in many cardiac and non-cardiac diseases. However, quite high values of the parameters help to distinguish the patients with cardiac systolic dysfunction.