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Role of Plasma B-Type Natriuretic Peptide in Screening for Hemodynamically Significant Patent Ductus Arteriosus in Preterm Neonates

Journal of Perinatology volume 25, pages 709–713 (2005)Cite this article

Abstract

BACKGROUND:

B-type natriuretic peptide (BNP) is a hormone secreted by the ventricles under hemodynamic stress and congestive failure.

OBJECTIVE:

The objective of the present study was to evaluate whether BNP can be used as a valid screening test for the presence of a hemodynamically significant patent ductus arteriosus (hsPDA) in the preterm neonate.

MATERIALS AND METHODS:

This was a prospective blinded study involving preterm neonates with birth weights ≤1500 g and gestational age ≤34 weeks. Each enrolled neonate underwent the initial echocardiogram for a clinical suspicion of patent ductus arteriosus (PDA) and BNP assay within 3 hours of each other. Those neonates who did not have a PDA or who were not treated underwent a repeat echo and BNP measurement 48 to 72 hours after the first echo. In patients who received treatment for a PDA, an echo and BNP were repeated 48 to 72 hours after completion of treatment.

RESULTS:

A total of 29 newborns with a median birth weight of 870 g (560 to 1325 g) and a median gestation of 26 weeks (24 to 31 weeks) were enrolled at a median age of 7 days (2 to 28 days). BNP levels were significantly higher in neonates with hsPDA (n=14) compared to those without (n=15) (508.5±618.2 vs 59.5±69.9 pg/ml, p<0.005). At a cutoff value of 70 pg/ml, BNP had a sensitivity of 92.9%, specificity of 73.3%, positive likelihood ratio of 3.5 and negative likelihood ratio of 0.09 for detection of hsPDA. BNP levels dropped significantly after medical or surgical closure of hsPDA (n=12), (404.9±159.2 to 25.1±4.1 pg/ml, p=0.03).

CONCLUSIONS:

Elevation of plasma BNP accurately detects the presence of hsPDA in premature infants. Successful closure is reflected by a corresponding decrease in BNP. At a cutoff of 70 pg/ml, BNP is a useful screening tool for diagnosis and for monitoring efficacy of treatment of hsPDA.

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Authors and Affiliations

  1. Division of Pediatric Cardiology, Children's Hosptial of Michigan, Detroit, MI, USA

    Sanjeev Sanjeev MD, Michael Pettersen MD, Jorge Lua MD, Ronald Thomas PhD, Seetha Shankaran MD & Thomas L'Ecuyer MD

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  1. Sanjeev Sanjeev MD
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  2. Michael Pettersen MD
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Sanjeev, S., Pettersen, M., Lua, J. et al. Role of Plasma B-Type Natriuretic Peptide in Screening for Hemodynamically Significant Patent Ductus Arteriosus in Preterm Neonates. J Perinatol 25, 709–713 (2005). https://doi.org/10.1038/sj.jp.7211383

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