{"id":"4f6379dc9067","type":"article","url":"https://hartvaat.nl/2025/08/01/nt-probnp-veranderingen-en-klinische-uitkomsten-bij-pediatrisch-hartfalen/","title":"NT-proBNP-veranderingen en klinische uitkomsten bij pediatrisch hartfalen","title_en":"Association between NT-proBNP changes and clinical outcomes in paediatric patients with heart failure: Insights from PANORAMA-HF and PARADIGM-HF.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":["acuut-hartfalen","nt-probnp"],"journal":"ESC heart failure","doi":"10.1002/ehf2.15326","source_url":"https://doi.org/10.1002/ehf2.15326","authors":["Robert Shaddy","Jianjian Gong","Tania Garito","Susan Solar-Yohay","Sijia Zhang","Margaret F Prescott","Damien Bonnet","Paul F Kantor","Michael Burch","Chad Mao","Antoinette Cilliers","Charles Canter","Yuk Law","Giorgia Grutter","Jou Kou Wang","Aamir Jeewa","Joseph Rossano"],"significance":5,"published":"2025-08-01","source_date":"2025-08-01","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/bnp-en-nt-probnp/","https://hartvaat.nl/kennis/diagnostiek/galectine-3-st2-hartfalen/"],"congress":"","summary_en":"Analysis of the PANORAMA-HF trial demonstrated that declining NT-proBNP levels correlate with improved clinical outcomes in paediatric heart failure. Serial biomarker monitoring informs treatment response assessment in this underserved population.","created":"2026-07-03T10:31:46Z","updated":"2026-07-03T13:30:45Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie onderzocht de prognostische waarde van NT-proBNP-veranderingen bij pediatrisch hartfalen. Dalende waarden waren geassocieerd met betere uitkomsten, wat seriële monitoring informeert.","abstract_original":"AIMS: The PANORAMA-HF trial demonstrated significant N-terminal pro-B-type natriuretic peptide (NT-proBNP) reductions in paediatric patients with left ventricular systolic dysfunction with sacubitril/valsartan or enalapril treatment over 52 weeks. This post hoc analysis aims to correlate changes in NT-proBNP levels with clinical outcomes in PANORAMA-HF patients receiving either sacubitril/valsartan or enalapril. Additionally, NT-proBNP reductions in the paediatric population were compared with a subset of adult heart failure with reduced ejection fraction (HFrEF) patients from the PARADIGM-HF trial. METHODS AND RESULTS: This post hoc analysis utilized data from Part 2 of the PANORAMA-HF trial. Associations between baseline NT-proBNP levels, changes post-baseline and the risk of HF clinical events in paediatric patients on sacubitril/valsartan or enalapril were assessed. The paediatric HF population from PANORAMA-HF was categorized into age groups (AG): AG1 (aged 6 to <18 years), AG2a (aged 2 to <6 years) and AG3a (aged 1 month to <2 years). The Cox proportional hazard model evaluated the relationship between NT-proBNP and clinical outcomes. Analysis of 361 paediatric patients (sacubitril/valsartan, n = 179; enalapril, n = 182) demonstrated overall higher baseline NT-proBNP levels in younger AGs. At Week 52, both treatment groups exhibited reduced NT-proBNP levels across all AGs. Reductions were comparable between sacubitril/valsartan and enalapril, with a numerically greater reduction observed in adult patients versus children. Strong associations between NT-proBNP levels and HF clinical outcomes were observed in paediatric populations in PANORAMA-HF and in adult DCM patients with HFrEF in PARADIGM-HF. Doubling of NT-proBNP levels was associated with a ≥1.7-fold increased risk of HF clinical events, while halving of the levels correlated with a 52% reduction in the risk of clinical events. CONCLUSIONS: This is the first prospective, randomized large-scale study to demonstrate a strong correlation between NT-proBNP levels and risks of HF clinical events in paediatric patients with HF."}