- Higher NT-proBNP levels associated with positive 24-hour Holter findings and cardiovascular complaints, despite no overall difference versus controls.
- Positive Holter findings occurred in 68.3% of patients; most were benign; 10.6% had potentially clinically significant abnormalities.
- ROC analysis: NT-proBNP AUC 0.779; cutoff ≥43.2 pg/mL yielded 66.7% sensitivity and 90.9% specificity for positive Holter findings.
Rev Paul Pediatr. 2026 Nov 2;44:e2026053. doi: 10.1590/1984-0462/2026/44/2026053. eCollection 2026.
ABSTRACT
OBJECTIVE: To assess plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in adolescents with chronic upper gastrointestinal diseases and investigate their association with 24-hour Holter electrocardiographic findings.
METHODS: This cross-sectional study included 104 adolescents with endoscopically-verified chronic upper gastrointestinal diseases and 58 comparison adolescents without clinically-documented chronic gastrointestinal or cardiovascular disease. Both groups underwent 24-hour Holter electrocardiographic monitoring. NT-proBNP was measured by enzyme-linked immunosorbent assay in 60 patients and 28 controls. Receiver operating characteristic analysis explored the ability of this biomarker to identify positive Holter findings, defined as rhythm, conduction, or repolarization abnormalities exceeding age-related physiological limits or requiring further cardiological evaluation.
RESULTS: Positive Holter findings were observed in 71 patients (68.3%). Most findings were benign; potentially clinically significant abnormalities occurred in 11 patients (10.6% of all patients; 15.5% of those with positive Holter findings). Median NT-proBNP levels did not significantly differ between patients and controls but were higher in patients with cardiovascular complaints (53.0 42.5-85.0 versus 22.6 12.4-41.4 pg/mL; p=0.001) and positive Holter findings (50.0 32.2-70.5 versus 27.8 10.7-41.4 pg/mL; p<0.05). According to the receiver operating characteristic analysis for identifying positive Holter findings, we observed an area under the curve of 0.779 (95% confidence interval 95%CI: 0.726-0.833; p<0.001). An NT-proBNP cutoff value of ≥43.2 pg/mL showed 66.7% sensitivity and 90.9% specificity for identifying positive Holter findings.
CONCLUSIONS: Higher NT-proBNP levels were associated with positive Holter findings. Given the cross-sectional design and limited monitoring period, this association requires prospective validation.
PMID:42987088 | PMC:PMC13730238 | DOI:10.1590/1984-0462/2026/44/2026053
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