N-terminal pro brain natriuretic peptide and cardiac function in doxorubicin administered pediatric patients

Objective: Assess the use of N terminal pro brain natriuretic peptide (NT-pro BNP) to early diagnose ventricular dysfunction in doxorubicin- administered children. Material and Method: Fifty-five cancer patients who received accumulative dose of doxorubicin <300 mg/m² (group 1), 49 cases with accumulative dose > 300 mg/m² (group 2) and 52 cases as a control group (group 3) were included in the study. Electrocardiogram, chest roentgenogram, echocardiogram, and serum NT-pro BNP were studied. Results: At age 1-10 years, there were significantly higher NT-pro BNP in group 2 than group1 (384 ± 291 vs. 92.2 ± 89 pg/ml; p = 0.001), and than group 3 (79 ± 92 pg/ml; p = 0.001). Patients with NT-pro BNP level > 1 SD of the control group were more likely to have abnormal > 2 echocardiographic parameters of left ventricular diastolic dysfunction than patients with NT-pro BNP < 1 SD (OR = 3.8, 95% CI 1.18-12.5). Patients in group 2 were more likely to have abnormal > 2 parameters of left ventricular diastolic dysfunction than patients in group 1 (OR = 2.8, 95% CI 1.07-7.7) and more likely to have NT-pro BNP >1 SD than group 1 (OR = 8, 95% CI 1.96-38.4). There were association of NT-pro BNP >1 SD, accumulative dose of doxorubicin > 300 mg/m², and early left ventricular diastolic dysfunction by echocardiogram. Conclusion: Serum NT-pro BNP >1 SD has a high probability to diagnose early doxorubicin-induced cardiomyopathy in patient 1-10 years old.