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N-terminal probrain natriuretic peptide and patent ductus arteriosus in preterm infants

Journal of Perinatology volume 29, pages 137–142 (2009)Cite this article

Abstract

Objective:

To determine whether plasma N-terminal probrain natriuretic peptide (NT-proBNP) in premature infants could identify hemodynamically significant patent ductus arteriosus (HsPDA) and to determine the correlation between serial plasma NT-proBNP and echocardiographic assessment of ductal shunting.

Study Design:

An observational study involving 35 preterm infants who underwent echocardiographic assessment for PDA on day 2, 4 and 7 of life with simultaneous blood sampling for determination of NT-proBNP concentrations. HsPDA was diagnosed by left-to-right ductal shunt on color Doppler, measuring diameter >1.5 mm on two-dimensional echocardiography plus ⩾2 clinical features of PDA.

Result:

Plasma NT-proNBP levels on day 2 in the HsPDA group (n=12) were significantly higher than in non-HsPDA group (n=23) with a median of 16 353 pg ml−1 (interquartile range (IQR), 12 360–33 459; range, 10 316–104 998) vs 3914 pg ml−1 (IQR, 2601–5782; range, 1535–19 516) (P<0.001), respectively. Eight infants (67%) in the HsPDA group responded to an initial course of indomethacin or ibuprofen and their NT-proBNP levels significantly decreased within 48 h after treatment compared with non-responders (P=0.007). NT-proBNP concentrations were significantly correlated with left atrial to aortic root ratio. A cut-off NT-proBNP on day 2 of 10 180 pg ml−1 offered the best predictive values for HsPDA with a sensitivity of 100% and a specificity of 91%.

Conclusion:

Plasma NT-proBNP on day 2 was found as a sensitive marker for predicting HsPDA in preterm infants. Successful closure of PDA was also correspondent with the decline in plasma NT-proBNP.

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Acknowledgements

The study is supported by the Ramathibodi Research Fund (grant no. 48055). The authors express their sincere thanks and gratitude to Professor Amnuay Thithapandha and Mahippathorn Chinnapha for their valuable comments and suggestions.

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  1. Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

    P Nuntnarumit, A Khositseth & P Thanomsingh

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Correspondence to P Nuntnarumit.

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Nuntnarumit, P., Khositseth, A. & Thanomsingh, P. N-terminal probrain natriuretic peptide and patent ductus arteriosus in preterm infants. J Perinatol 29, 137–142 (2009). https://doi.org/10.1038/jp.2008.185

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