Accuracy of brain natriuretic peptide and N-terminal brain natriuretic peptide for detecting paediatric pulmonary hypertension: a systematic review and meta-analysis

Figures & data

Figure 1. The selection process of included studies.

Table 1. Characteristics of the included articles.

Author	Year	Country	Study design	Disease type	PH/non-PH participants (N)	Index test		Reference standard
						Type	Cut-off (pg/ml)
Jin N [2]	2023	China	Cross-sectional	CHD-PH	65/92	NT-proBNP	492	Cardiac catheterization
Nova R [15]	2022	Indonesia	Cross-sectional	CHD-PH	33/42	NT-proBNP	554	Echocardiography
Tufekci S [16]	2022	Turkey	Cross-sectional	PPHN	33/50	NT-proBNP	2760	Echocardiography
Zhang H [17]	2021	China	Prospective cohort	CHD-PH	54/25	NT-proBNP	521	Cardiac catheterization
Dasgupta S [5]	2021	USA	Prospective cohort	CHD-PH	10/21	NT-proBNP	408	Cardiac catheterization
Griffiths M [18]	2020	USA	Prospective cohort	PH	26/21	NT-proBNP	262	Echocardiography
Naeem B [19]	2020	USA	Cross-sectional	BPD-PH	6/20	NT-proBNP	2345	Echocardiography
Behere S [20]	2019	USA	Retrospective cohort	BPD-PH	7/21	BNP	100	Echocardiography
Avitabile CM [21]	2019	USA	Retrospective cohort	BPD-PH	68/60	BNP	130	Echocardiography
Rodriguez-Gonzalez M [22]	2019	Spain	Prospective cohort	PH	21/72	NT-proBNP	1345	Echocardiography
Dasgupta S [23]	2018	USA	Prospective cohort	BPD-PH	8/28	NT-proBNP	2329	Echocardiography
Pektaş A [24]	2017	Turkey	Retrospective cohort	CHD-PH	25/40	BNP	305	Cardiac catheterization
Li G [25]	2017	China	Cross sectional	CHD-PH	46/39	NT-proBNP	112	Cardiac catheterization
Li G [26]	2016	China	Cross sectional	CHD-PH	30/30	BNP	Un	Cardiac catheterization
Montgomery AM [27]	2016	USA	Cross-sectional	BPD-PH	5/15	NT-proBNP	1000	Echocardiography
Cuna A [28]	2013	USA	Cross-sectional	BPD-PH	16/9	BNP	117	Echocardiography
Reynolds EW [29]	2004	USA	Prospective cohort	PPHN	15/15	BNP	550	Echocardiography
Suda P [30]	2003	Japan	Cross-sectional	CHD-PH	30/29	BNP	20	Cardiac catheterization

Abbreviations: PH: pulmonary hypertension; CHD: congenital heart disease; PPHN, neonatal persistent pulmonary hypertension; BPD: bronchopulmonary dysplasia; BNP: brain natriuretic peptide; NT-proBNP: N-terminal pro-brain natriuretic peptide.

Figure 2. Quality for the included articles.

Figure 3. Hierarchical summary receiver operating characteristic plot to summarize diagnostic performance of BNP/NT-proBNP for detecting paediatric PH.

Figure 4. Hierarchical summary receiver operating characteristic plot to summarize diagnostic performance of BNP for detecting paediatric PH.

Figure 5. Hierarchical summary receiver operating characteristic plot to summarize diagnostic performance of NT-proBNP for detecting paediatric PH.

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Nova R, Putra ST, Nurmaini S, et al. The association between NTproBNP biomarker levels and clinical symptoms of cardiac septal defects in children. Open Access Maced J Med Sci. 2022;10(B):1047–1051. doi: 10.3889/oamjms.2022.8531.

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Tufekci S, Kizilca O, Aygun E. N-terminal prohormone of brain natriuretic peptide in the diagnosis and management of persistent pulmonary hypertension in newborns. J Ist Faculty Med. 2022;85:228–235.

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Naeem B, Ayub A, Aly AM, et al. Urinary NT-proBNP as a potential noninvasive biomarker for screening of pulmonary hypertension in preterm infants: a pilot study. J Perinatol. 2020;40(4):628–632. doi: 10.1038/s41372-019-0581-9.

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Dasgupta S, Aly AM, Malloy MH, et al. NTproBNP as a surrogate biomarker for early screening of pulmonary hypertension in preterm infants with bronchopulmonary dysplasia. J Perinatol. 2018;38(9):1252–1257. doi: 10.1038/s41372-018-0164-1.

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Pektaş A, Olguntürk R, Kula S, et al. Biomarker and shear stress in secondary pediatric pulmonary hypertension. Turk J Med Sci. 2017;47(6):1854–1860. doi: 10.3906/sag-1609-13.

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Li G, Li Y, Tan X, et al. Plasma growth differentiation factor-15 is a potential biomarker for pediatric pulmonary arterial hypertension associated with congenital heart disease. Pediatr Cardiol. 2017;38(8):1620–1626. doi: 10.1007/s00246-017-1705-7.

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Li G, Tang L, Jia P, et al. Elevated plasma connective tissue growth factor levels in children with pulmonary arterial hypertension associated with congenital heart disease. Pediatr Cardiol. 2016;37(4):714–721. doi: 10.1007/s00246-015-1335-x.

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Montgomery AM, Bazzy-Asaad A, Asnes JD, et al. Biochemical screening for pulmonary hypertension in preterm infants with bronchopulmonary dysplasia. Neonatology. 2016;109(3):190–194. doi: 10.1159/000442043.

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Cuna A, Kandasamy J, Fineberg N. B-type natriuretic pep- tide is a biomarker for pulmonary hypertension in preterm infants with bronchopulmonary dysplasia. Res Rep Neonatol. 2013;3:33–36.

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Reynolds EW, Ellington JG, Vranicar M, et al. Brain- type natriuretic peptide in the diagnosis and management of persistent pulmonary hypertension of the newborn. Pediatrics. 2004;114(5):1297–1304. doi: 10.1542/peds.2004-0525.

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Suda K, Matsumura M, Matsumoto M. Clinical implication of plasma natriuretic peptides in children with ventricular septal defect. Pediatr Int. 2003;45(3):249–254. doi: 10.1046/j.1442-200x.2003.01716.x.

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Data availability statement

Data are available of this study. All data are collected and analysed from the published studies which are served as references in this systematic review and meta-analysis. The corresponding author (Xia Qiu) could provide the raw data for statistical analysis by request.