OBJECTIVE: To assess the values of serum fatty acid-binding protein （FABP) and brain natriuretic peptide (BNP） in pneumonia complicated by acute congestive heart failure (CHF) in children.METHODS: Serum levels of FABP and BNP were determined using ELISA in 36 children with pneumonia complicated by CHF (pneumonia group) and 28 healthy children (control group).RESULTS: Serum levels of FABP and BNP in the pneumonia group at the acute stage were significantly higher than those in the control group and those at the recovery stage (P<0.01). Compared with the control group, serum levels of FABP and BNP in the pneumonia group at the recovery stage increased significantly (P<0.01). At the acute stage, 35 patients (97.2%) showed increased serum FABP level but 28 (77.8%) showed increased serum BNP level (P<0.05) in the pneumonia group. At the recovery stage, the incidence of abnormal serum FABP (72.2%) was significantly higher than that of BNP (44.4%) in the pneumonia group (P<0.05).CONCLUSIONS: Serum levels of FABP and BNP can be regarded as biochemical markers of myocardial damage in children with pneumonia complicated by CHF and serum FABP appears to be a more sensitive one. Serum FABP and BNP remained at higher levels through the recovery stage, suggesting that myocardial damage existed though the clinical symptoms were improved at the stage.