Author + information
- Jannet A. Eindhoven, MD,
- Annemien E. van den Bosch, MD, PhD,
- Eric Boersma, PhD and
- Jolien W. Roos-Hesselink, MD, PhD⁎ ()
- ↵⁎Department of Cardiology, Ba-583, Erasmus Medical Center-Rotterdam, Department of Cardiology, ′s-Gravendijkwal 230, 3015 CE Rotterdam, the Netherlands
We thank Dr. Cantinotti and colleagues for their interest in our article (1) and for their valuable addition. We fully agree with Cantinotti et al. that brain natriuretic peptides (NPs) are of potential use for other purposes as differential diagnosis and to guide medical and surgical management of congenital heart disease (CHD). In our systematic review we aimed to provide a clear overview of average NP levels for the 3 most commonly encountered complex congenital heart defects and the relation with cardiac function to determine its possible use in the cardiologists' daily practice. The use of this biomarker at young pediatric age is so far mainly studied in mixed cohorts of various forms of CHD (2). As we looked at disease-specific NP values, these studies were not included in our review article. Nevertheless, daily changes in BNP in the first days of life and suggested cutoff values for NPs in this period clearly provide valuable diagnostic information for both neonatologists and pediatric cardiologists.
Cantinotti et al. also note that the various assay methods used to determine NP levels measure different NP concentrations and have assay method–specific cutoff values (3). We acknowledge this fact, and it was our main reason to withhold us from a direct comparison of the observed NP values by performing a formal meta-analysis. By reporting both NP values for CHD patients and, when reported, NP values for healthy controls per study (Figure 2 ), we aimed to demonstrate the observed differences objectively without drawing any overall conclusions. Despite known differences between assay kits, the measured NP levels and observed correlations were comparable, strengthening the potential clinical use of NPs in CHD (1). Furthermore, the additional prognostic value of the marker remains to be clarified by larger longitudinal studies.
- American College of Cardiology Foundation
- Eindhoven J.A.,
- van den Bosch A.E.,
- Jansen P.R.,
- Boersma E.,
- Roos-Hesselink J.W.
- Clerico A.,
- Emdin M.