Significance of adrenomedullin and C-type natriuretic peptide in diagnosis of chronic heart failure in children

[Objective] To evaluate potential use of adrenomedullin(ADM) and C-type natriuretic peptid(CNP) in diagnosis of chronic heart failure. [Methods] measured ADM and CNP concentration of 42 CHF children and 11 healthy children, and compared their sensitivity, specificity, positive predicative values, negative predictive values, accuracy and Youden index for CHF diagnosis. [Result] ①The area under the receiver operating charcteristic (ROC) curve, which determines the diagnostic accuracy of ADM in CHF, was 90.3% (P0.01); the area about CNP was 75.5% (P0.01). ADM level of 92.65 pg/ml had sensitivity of 92.9%, specificity of 81.8%, positive predictive value of 95.1%, negative predictive of 75% and Youden index of 74.7% for diagnosing CHF. CNP level of 116.07 pg/ml had sensitivity of 76.2%, specificity of 72.7%, positive predictive of 91.4%, negative predictive value of 44.4% and Youden index of 48.9% for diagnosing CHF. Both of the indices, ADM had the highest sensitivity, specificity, positive predictive, negative predictive, Youden index and accuracy. ②There was significantly positive correlation between the levels of ADM and the severity of CHF (r=0.62, P0.01). The severity of CHF was shown to be slightly positively correlated with plasma CNP levels (r=0.36, P0.05). [Conclusion] ADM ≥92.69 pg/ml is a highly sensitive and moderately specific index for chileren CHF diagnosis.