NT-proBNP levels improve the ability of predicting a hemodynamically significant patent ductus arteriosus in very low-birth-weight infants

Abstract

Purpose:A hemodynamically significant Patent ductus arteriosus (HsPDA) in premature infants is known to be associated with significant morbidity. Recently brain natriuretic peptides and superior mesenteric artery (SMA)-resistive indices have been used to effectively diagnose HsPDA.Objective:To assess the sensitivity and specificity of N-terminal proBNP (NT-proBNP) in predicting an HsPDA diagnosed by clinical and echocardiographic criteria including pulsatility index (PI) of SMA.Materials and Methods:All preterm neonates <1500 g were evaluated with echocardiograms and NT-proBNP levels on the 3rd to 5th day of life and then every week until the echo showed either a closed PDA or non-HsPDA.Results:Sixty-nine babies with mean gestational age of 27 weeks were included in the study. NT-proBNP levels were significantly higher in the HsPDA group (n=22) with a mean±SEM of 24420±3190 compared to 3072±332 in the non-HsPDA group (n=47) (P<0.001). NT-pro BNP level of 5900 pg/ml had 96% sensitivity and 90% specificity of predicting HsPDA.Conclusions:With frequently changing hemodynamics in low-birth weight infants, including NT-proBNP and PI of SMA improve the ability of assessing the effects of a HsPDA and will help timing of intervention.

N-terminal pro-brain natriuretic peptide measurementsin hemodynamically significant patent ductus arteriosus in preterm infants

“…In HsPDA there is significant shunting of blood from the systemic to the pulmonary circuit resulting in increased pulmonary blood flow with reduction in effective systemic blood flow. 8 Therefore, HsPDA is considered to be associated with various comorbid illnesses in premature infants, 9 observed in more than 30% of premature infants with gestational ages of <32 weeks. 10 Early diagnosis of hsPDA allows early treatment and probable reduction of morbidity in preterm infants.…”

Evaluation of Circulating Cardiovascular Biomarker Levels for Early Detection of Congenital Heart Disease in Newborns in Sweden

“… 48 , 49 , 50 Gestational age plays a role in NT-proBNP levels, as demonstrated in premature neonates with and without PDA (the pattern of NT-proBNP levels is higher in neonates with PDA than in those in whom the PDA is closed), and NT-proBNP levels seem to follow a similar postnatal pattern in term neonates (in whom the levels decline over the first few days of life). 51 , 52 We did not recruit premature neonates or those who required neonatal inpatient care, populations in which the new test warrants further evaluation.…”

The Role of Natriuretic Peptides in Management of Premature Infants with Hemodynamically Significant Patent Arterial Duct

“…Значение натрийуретических пептидов в диагностике гемодинамически значимого функционирующего артериального протока у недоношенных Главным вектором в определении практической значимости определения BNP у недоношенных детей с ГЗФАП является изучение корреляции ЭхоКГ-критериев гемодинамической значимости протока с уровнем BNP [17,29]. Основные выявленные закономерности -это высокий уровень BNP при наличии ЭхоКГ-признаков ГЗФАП у недоношенных пациентов [22,30,31].…”

“…Значение натрийуретических пептидов в определении тактики ведения недоношенных с гемодинамически значимым функционирующим артериальным протоком Вопрос оптимальных сроков хирургической коррекции ГЗФАП остается до конца нерешенным. В этой связи в исследованиях, изучающих BNP у недоношенных пациентов с ГЗФАП, по-прежнему большое внимание уделяется интерпретации полученных данных в контексте принятия решения о тактике лечения [17,30,31].…”