Evidence map›Paper›PMID 40353367›Full record

Trial reportESC heart failure2025

Association between NT-proBNP changes and clinical outcomes in paediatric patients with heart failure: Insights from PANORAMA-HF and PARADIGM-HF.

Robert Shaddy, Jianjian Gong, Tania Garito, Susan Solar-Yohay, Sijia Zhang, Margaret F Prescott, Damien Bonnet, Paul F Kantor, Michael Burch, Chad Mao and 8 more

Abstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in ESC heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Robert ShaddyChildren's Hospital Los Angeles and the Keck School of Medicine of the University of Southern California, Los Angeles, California, USA.ORCID https://orcid.org/0000-0002-1830-5238
Jianjian GongNovartis Pharmaceuticals, East Hanover, New Jersey, USA.
Tania GaritoNovartis Pharma AG, Basel, Switzerland.
Susan Solar-YohayNovartis Pharmaceuticals, East Hanover, New Jersey, USA.
Sijia ZhangNovartis Pharma, Shanghai, China.
Margaret F PrescottNovartis Pharmaceuticals, East Hanover, New Jersey, USA.
Damien BonnetM3C-Necker, Congenital and Paediatric Cardiology Department, Hospital Necker-Enfants Malades, University of Paris Cité, Paris, France.
Paul F KantorChildren's Hospital Los Angeles and the Keck School of Medicine of the University of Southern California, Los Angeles, California, USA.
Michael BurchGreat Ormond Street Hospital for Children, London, UK.
Chad MaoChildren's Healthcare of Atlanta and Emory University, Atlanta, Georgia, USA.
Antoinette CilliersChris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa.
Charles CanterWashington University School of Medicine, St Louis, Missouri, USA.
Yuk LawSeattle Childrens Hospital, Seattle, Washington, USA.
Giorgia GrutterIRCCS Bambino Gesu Children Hospital, Rome, Italy.
Jou Kou WangNational Taiwan University Hospital, Taipei City, Taiwan.
Aamir JeewaThe Hospital for Sick Children, Toronto, Ontario, Canada.
Joseph RossanoChildren's Hospital of Philadelphia (CHOP), Philadelphia, Pennsylvania, USA.
PANORAMA‐HF investigators

Funding

Novartis Pharma AG, Basel, Switzerland
6 · The paper itself

Abstract

aimsThe 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

resultsThis 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.

conclusionsThis 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.

Indexed as

AminobutyratesHeart FailureNatriuretic Peptide, BrainPeptide FragmentsStroke VolumeVentricular Function, LeftAdolescentAdultAngiotensin Receptor AntagonistsBiomarkersBiphenyl CompoundsChildChild, PreschoolDrug CombinationsEnalaprilFemaleAminobutyratesAngiotensin Receptor AntagonistsBiomarkersBiphenyl CompoundsDrug CombinationsEnalaprilNatriuretic Peptide, BrainPeptide Fragmentspro-brain natriuretic peptide (1-76)sacubitril and valsartan sodium hydrate drug combinationTetrazolesValsartanLeft ventricular systolic dysfunctionNT‐proBNPPaediatric heart failureSacubitril/valsartan

Identifiers

PMID40353367
PMCPMC12287839

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.