Brain natriuretic peptide and its inactive fragment N-terminal pro-BNP (N-BNP) are reliable markers of ventricular dysfunction in adults and children. are comparable to the median value of infants with severe HF (= 12) 673 (408-11310)?pg/mL. There is no statistical significant difference in AZD0530 age. < .05 was considered statistically significant. The Mann-Whitney test was utilized for comparison of N-BNP values of our patients and the original data from healthy infants published by Norozi et al.  and Koch et al. . The data ANPEP analyses were performed using Excel AZD0530 2000 (Microsoft USA) and Prism (GraphPad software Inc. USA). The study was approved by the local ethic committee. 3 Results Demographic and height and excess weight characteristics for the three study groups are summarized in Table 1. 26 patients were included in our study the CD group contained 15 patients and the HF group contained 11 patients. 5 patients were excluded due to organic causes. As shown in Table 1 there is no significant statistical difference in age bodyweight body length gestational age and head circumference in the CD group and the HF group. Gestational age and birth excess weight were AZD0530 within normal limits. The CD group experienced a significantly lower postnatal weight gain 73 (0-147)?g/week at home mostly caused AZD0530 by inadequate breast feeding at home compared with the weight gain during hospital stay 225 (100-500)?g/week. Further laboratory investigations show no significant difference for haemoglobin white blood cells ALT and creatinine values in infants with HF compared to the infants with FTT. All these data were within the normal range. Table 1 Growth characteristics. The HF group included 7 infants prior to cardiac surgery (ventricular septal defects or atrioventricular septal defects). Four infants suffered from severe HF more than 2 weeks after cardiac surgery AZD0530 (transposition of the great arteries single ventricle). Seven infants with severe HF received a medical therapy with digoxin diuretics angiotensin transforming enzyme inhibitors and/or beta-blocker. The laboratory investigations are shown in Table 2. For statistical analysis we compared the CD group with healthy infants and with the HF group. Our results show that infants with FTT experienced significantly elevated N-BNP values compared with the healthy infants 115 (15-1121)?pg/mL versus 530 (119-3150)?pg/mL < .001. N-BNP values in the CD group are not significantly different from values of infants with severe HF 673?pg/mL (408 - 35000)?pg/mL. As shown in Physique 1 N-BNP of our healthy infants group is in accordance with the reference values from the literature . The median is nearly 4-fold higher in infants with FTT. 4 Discussion Brain natriuretic peptide is usually secreted mainly by cardiac myocytes of the ventricles and to a lesser degree of the atria. Natriuretic peptides are released from your heart in response to pressure and volume overload . However several recent studies demonstrate an inverse relationship between body mass index and N-BNP levels were completed in adults with and without severe HF . In this study we present significant N-BNP elevations in a group of 15 infants with CD. These infants only suffer from an inadequate caloric intake without any evidence for severe HF congenital heart disease and liver or kidney disease. HF and congenital heart disease in the CD group were excluded by echocardiography. There was no evidence of diastolic dysfunction around the echocardiograms indicated by normal mitral valve inflow profiles. In our study the age of the remaining infants was in good accordance with the reference group of the literature . The median N-BNP level of our infants with FTT 530 (119-3150)?pg/mL) is comparable to children with Ross class III HF (744?pg/mL) . Our heart failure group included only infants with severe HF with a very high N-BNP level of 408-35000?pg/mL. Interestingly 58 of these infants with severe HF also suffer from FTT. These data are in good accordance with data from a pilot study regarding N-BNP in patients with HF due to ventricular septal defects showing that this perioperative switch in N-BNP was most closely correlated with improved weight gain . Also it is well.