Diagnostic value of serum brain natriuretic peptide in syncope in children and adolescents.

AIM: This study was designed to evaluate the diagnostic value of B-type natriuretic peptide (BNP) in syncope in children and adolescents.
METHODS: Serum BNP concentration was measured by electrochemiluminescence assay in 62 consecutive children and adolescents hospitalized for syncope.
RESULTS: Of the 62 children and adolescents hospitalized for syncope, 39 had noncardiac syncope, of whom 37 (59.7%) had autonomic-mediated reflex syncope and two (3.2%) had syncope of unknown cause. Twenty-three patients (37.1%) had cardiac syncope: 11 of these had cardiac arrhythmias and 12 had structural cardiac/cardiopulmonary disease. Patients with cardiac syncope had significantly higher serum BNP than those with non-cardiac syncope (958.78 ± 2443.41 pg/mL vs 31.05 ± 22.64 pg/mL, p < 0.05). Logistic multivariate regression analysis revealed that urinary incontinence during syncopal episodes, ECG abnormalities and increased serum BNP levels were independent predictors of cardiac syncope. At a cut-off value of 40.65 pg/mL, serum BNP was associated with significant risk of a cardiac cause of syncope, with sensitivity of 73.9% and specificity of 70.0% for distinguishing cardiac syncope from noncardiac syncope.
CONCLUSION: Serum BNP was helpful in differentiating cardiac syncope from noncardiac syncope in children and adolescents. ©2013 The Author(s)/Acta Paediatrica ©2013 Foundation Acta Paediatrica.