Molecular Forms of Plasma and Urinary B-type Natriuretic Peptide and Its N-terminal Prohormone in Health and Disease in Pediatric Cardiology
Molecular Forms of Plasma and Urinary B-type Natriuretic Peptide and Its N-terminal Prohormone in Health and Disease in Pediatric Cardiology
B-type natriuretic Peptide (BNP) is a cardiac hormone secreted from the cardiac myocytes in
 response to volume load. Plasma levels of BNP, as measured by immunoassay methods, are
 elevated in patients with heart diseases. However, the biological effects of BNP are blunted
 in heart failure and other cardiac conditions. Moreover, the peptide levels are also elevated
 in non cardiac conditions such as the neonatal period, sepsis and renal failure. Recent
 investigations suggest alteration of the peptide molecular structure in heart failure. These
 alterations may explain, at least partially, the reduced biological activities of BNP in
 heart failure.

 Immunoreactive BNP and NT-proBNP have been identified in human urine. It has been suggested
 that urinary BNP correlates with plasma BNP, and may serve as a non-invasive measure for this
 cardiac marker. It is unclear what BNP fractions are cleared in the urine in health and
 disease.

 The aim of the proposed studies is to elucidate precisely the molecular form of BNP in
 various disease and specific physiological states in plasma and urine of infants and
 children.
Inclusion Criteria:

 1. Healthy newborn infants with normal pregnancy and delivery

 2. Premature infants

 3. Infants and children with heart disease who have NT-proBNP levels taken as part of
 cardiac evaluation

 Exclusion Criteria:

 1. Patients with non cardiac disease (renal, hepatic)

 2. Patients with acute urinary disease or other acute non-cardiac diseases.