In Reply.—

I thank Baptista et al for their interest in my research. In the article, my co-workers and I hypothesized that brain-type natriuretic peptide (BNP) levels would be elevated in any pathologic condition that resulted in abnormal stress on the ventricles. This would be true of some, but not all, forms of congenital heart disease. It seems from the preliminary data that the doctors are on their way to confirming that hypothesis.

We excluded infants with congenital heart disease from our study because of potential limitations of using the BNP assay in this setting that occurred to us while planning for this project. First, BNP is a marker for ventricular stress. It is not specific to any particular disease state. Although BNP is elevated in infants with persistent pulmonary hypertension (PPHN), it can also be expected to be elevated in any infant with congenital heart disease that...

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