N-terminal Pro-B-type natriuretic peptide: a measure of significant patent cuctus arteriosus

Hdl Handle:
http://hdl.handle.net/10147/263350
Title:
N-terminal Pro-B-type natriuretic peptide: a measure of significant patent cuctus arteriosus
Authors:
OFarombi-Oghuvbu, IO; Matthews, Thomas; Mayne, Philip D; Guerin, Hilda; Corcoran, David
Citation:
Arch Dis Child Fetal Neonatal Ed 2008;93:F257-F260
Publisher:
BMJ
Journal:
Arch Dis Child Fetal Neonatal Ed
Issue Date:
24-Jan-2008
URI:
http://hdl.handle.net/10147/263350
DOI:
doi:10.1136/adc.2007.120691
Abstract:
Background: B type natriuretic peptide (BNP) is a marker for ventricular dysfunction secreted as a pre-prohormone, Pro-B-type natriuretic peptide (ProBNP), and cleaved into BNP and a biologically inactive fragment, N-terminal pro-B-type natriuretic peptide (NT-proBNP). Little is known about the clinical usefulness of NT-proBNP in preterm infants. Objective: To evaluate the usefulness of plasma NT-proBNP in diagnosing hsPDA in neonates and examine some factors that could affect this. Methods: Infants born at <34 weeks gestation (GA) and < 2kg birth weight (BW) were prospectively enrolled within 6 to 12 hours of birth. Plasma NT-proBNP levels were measured on days 1, 3, 5 and 10 with simultaneous echocardiography done to detect hsPDA and assess ventricular function. Significant PDA diagnosed by large ductal flow with left to right shunt on colour Doppler measuring >1.6mm on 2D echocardiography along with clinical features of PDA. Results: Forty-nine infants analysed. Median GA 30 weeks (range: 24-33) and median BW 1220 grams (range: 550-1950gm). Eighteen hsPDA infants had higher day 3 plasma NT-proBNP values (median 32907pg/mL; range: 11396-127155) (p<0.001) compared with controls (median 3147pg/mL; range: 521-10343). Infants who developed sepsis had higher day 10 plasma NT-proBNP levels. Area under ROC curve for detection of hsPDA, by day 3 NT-proBNP value, was significant 0.978 (95% CI: 0.930-1.026). NT-proBNP was predictive of hsPDA (sensitivity 100%; specificity 95%) at cut-off value of 11395pg/mL. Conclusion: Plasma NT-proBNP level on day 3 is a good marker for hsPDA in preterm infants. Serial measurements of NT-proBNP may be useful in assessing the clinical course of PDA.
Item Type:
Article
Language:
en
Local subject classification:
CHEMICAL PATHOLOGY

Full metadata record

DC FieldValue Language
dc.contributor.authorOFarombi-Oghuvbu, IOen_GB
dc.contributor.authorMatthews, Thomasen_GB
dc.contributor.authorMayne, Philip Den_GB
dc.contributor.authorGuerin, Hildaen_GB
dc.contributor.authorCorcoran, Daviden_GB
dc.date.accessioned2012-12-20T11:10:28Z-
dc.date.available2012-12-20T11:10:28Z-
dc.date.issued2008-01-24-
dc.identifier.citationArch Dis Child Fetal Neonatal Ed 2008;93:F257-F260en_GB
dc.identifier.doidoi:10.1136/adc.2007.120691-
dc.identifier.urihttp://hdl.handle.net/10147/263350-
dc.description.abstractBackground: B type natriuretic peptide (BNP) is a marker for ventricular dysfunction secreted as a pre-prohormone, Pro-B-type natriuretic peptide (ProBNP), and cleaved into BNP and a biologically inactive fragment, N-terminal pro-B-type natriuretic peptide (NT-proBNP). Little is known about the clinical usefulness of NT-proBNP in preterm infants. Objective: To evaluate the usefulness of plasma NT-proBNP in diagnosing hsPDA in neonates and examine some factors that could affect this. Methods: Infants born at <34 weeks gestation (GA) and < 2kg birth weight (BW) were prospectively enrolled within 6 to 12 hours of birth. Plasma NT-proBNP levels were measured on days 1, 3, 5 and 10 with simultaneous echocardiography done to detect hsPDA and assess ventricular function. Significant PDA diagnosed by large ductal flow with left to right shunt on colour Doppler measuring >1.6mm on 2D echocardiography along with clinical features of PDA. Results: Forty-nine infants analysed. Median GA 30 weeks (range: 24-33) and median BW 1220 grams (range: 550-1950gm). Eighteen hsPDA infants had higher day 3 plasma NT-proBNP values (median 32907pg/mL; range: 11396-127155) (p<0.001) compared with controls (median 3147pg/mL; range: 521-10343). Infants who developed sepsis had higher day 10 plasma NT-proBNP levels. Area under ROC curve for detection of hsPDA, by day 3 NT-proBNP value, was significant 0.978 (95% CI: 0.930-1.026). NT-proBNP was predictive of hsPDA (sensitivity 100%; specificity 95%) at cut-off value of 11395pg/mL. Conclusion: Plasma NT-proBNP level on day 3 is a good marker for hsPDA in preterm infants. Serial measurements of NT-proBNP may be useful in assessing the clinical course of PDA.en_GB
dc.language.isoenen
dc.publisherBMJen_GB
dc.subject.otherCHEMICAL PATHOLOGYen_GB
dc.titleN-terminal Pro-B-type natriuretic peptide: a measure of significant patent cuctus arteriosusen_GB
dc.typeArticleen
dc.identifier.journalArch Dis Child Fetal Neonatal Eden_GB
dc.description.provinceLeinsteren
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