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Urinary NT-proBNP levels and echocardiographic parameters for patent ductus arteriosus

Journal of Perinatology volume 37, pages 1319–1324 (2017)Cite this article

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Abstract

Objective:

Patent ductus arteriosus (PDA) is common in preterm infants and is associated with significant morbidities. B type natriuretic peptide (BNP) is synthesized in the ventricles secondary to volume overload and excreted as urinary N-terminal pro-brain natriuretic peptide (NT-proBNP).

Study Design:

We report an observational prospective study of 64 preterm infants with birth weight ⩽1000 g. Echocardiographic parameters were obtained from clinical echocardiograms performed in the first week of life. Urinary NT-proBNP/creatinine ratios (pg mg−1) were measured on the same day of the echocardiograms.

Results:

Infants with medium to large PDA (n=39) had significantly higher NT-proBNP/creatinine levels compared with infants with small PDA (n=10) (median (IQ range): 2333 (792–6166) vs 714 (271–1632) pg mg−1, P=0.01) and compared with infants with no PDA (n=15) (2333 (792–6166) vs 390 (134–1085) pg mg−1, P=0.0003). Urinary NT-proBNP/creatinine ratios were significantly lower post treatment if PDA closed (n=17), P=0.001 or if PDA became smaller after treatment (n=9), P=0.004. Urinary NT-proBNP/creatinine levels correlated with ductal diameter (P⩽0.0001), but not with LA/Ao ratio (P=0.69) or blood flow velocity through the ductus (P=0.06).

Conclusion:

Our findings indicate that there is a positive correlation between ductal diameter and urinary NT-proBNP in preterm infants.

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Acknowledgements

The project described was supported by the National Center for Advancing Translational Sciences, UL1TR000117, the Dean of the College of Medicine, University of Kentucky and Children’s Miracle Network (CMN) grant awarded to Kentucky Children’s Hospital. We thank our research nurses Vicky Whitehead and Deb Grider for their assistance.

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, College of Medicine, University of Kentucky, Lexington, KY, USA

    S S Khan, T Sithisarn, H S Bada & M Hanna

  2. Division of Pediatric Cardiology, Department of Pediatrics, College of Medicine, University of Kentucky, Lexington, KY, USA

    M Vranicar

  3. Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, USA

    P M Westgate

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  1. S S Khan
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Correspondence to M Hanna.

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Khan, S., Sithisarn, T., Bada, H. et al. Urinary NT-proBNP levels and echocardiographic parameters for patent ductus arteriosus. J Perinatol 37, 1319–1324 (2017). https://doi.org/10.1038/jp.2017.139

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