The utility of n-terminal probnp levels in distinguishing between cardiac and non-cardiac diseases in pediatric pati̇ents who present to the emergency department andhave N-Terminal pro-BNP levels requested

Objective: In our study, we will investigate how N-Terminal pro-BNP levels will change in patients who present to the emergency department and have N-Terminal pro-BNP levels requested, and whether these levels will help distinguish between cardiac and non-cardiac diseases. Materials and Methods: The medical records of 2000 patients aged 0-18 years who presented to the Pediatric Emergency Department of the Ankara City Hospital and Children's Hospital, affiliated with the Ministry of Health University, for cardiac and non-cardiac diseases and had N-Terminal pro-BNP levels requested, were retrospectively reviewed between August 2019 and August 2022. Results: A total of 519 patients (25.95%) out of 2000 aged 0-18 years who presented to the Pediatric Emergency Department for cardiac and non-cardiac diseases and had NT pro-BNP levels requested were excluded from the study. Among the included participants, 8.3% (f=166) were in the cardiac group, and 66% (f=1315) were in the non-cardiac group. Within the cardiac group, the most common diagnosis was congenital heart disease (6.9%), while cardiomyopathy was the least common (0.5%). In the non-cardiac group, respiratory tract infections (RTI=33.6%) were more prevalent than COVID/MIS-C (12.1%), gastrointestinal system infections (GI=18.2%), and urinary tract infections (UTI=2%), with urinary tract infections being the least common. The median value in the cardiac group (675) was higher than that in the non-cardiac group (112). According to the Mann-Whitney U Test results calculated to determine whether this difference was significant, the NT pro-BNP rank mean in the cardiac group was significantly higher than that in the non-cardiac group (U=31080, Z=-11.07, p<0.001). When examining the rates of NT pro-BNP positivity (elevated levels) in cardiac and non-cardiac patients, it was observed that 75.3% of patients in the cardiac group were positive for NT pro-BNP. In non-cardiac patients, the NT pro-BNP positivity rate was found to be 34.8%. It was noted that the positivity rates for NT pro-BNP were not the same between cardiac and non-cardiac patients. Results from the two-way Chi-square test indicated that the difference in NT pro-BNP positivity rates between cardiac and non-cardiac patients was statistically significant (X2 (14) = 101.4, p < 0.001). Conclusion: It was observed that NT pro-BNP levels were higher in non- cardiac patients (respiratory tract infections, gastrointestinal system infections, urinary tract infections, and COVID/MIS-C) than in healthy individuals, but lower than in cardiac patients (myocarditis, cardiomyopathy, congenital heart anomalies). It can be stated that NT pro-BNP levels are useful in distinguishing between cardiac and non- cardiac diseases. Keywords: NT pro-BNP, child, cardiac, non-cardiac.