title: Plasma brain natriuretic peptide as a predictor of haemodynamically significant patent ductus arteriosus in preterm infants.
abstract: Patent ductus arteriosus (PDA) is an important cause of morbidity in extremely preterm infants. As increased plasma brain natriuretic peptide (BNP) is a common feature of adult cardiac disease, we investigated the value of plasma BNP concentration as a predictor of haemodynamically significant PDA in very preterm infants. We studied 18 preterm infants (12 male) of median gestational age 30 weeks (range 24-34), median birth weight 1.46 kg (0.54-2.13) and 11 healthy term controls. Plasma BNP levels were measured by double-antibody radioimmunoassay on days 3, 5 and 7 of life, and an echocardiogram was performed on day 7. Six infants of median gestation 26 weeks (26-30), median birth weight 0.92 kg (0.54-1.04) had PDA proven by echocardiography on day 7. BNP concentrations (pg/ml) on day 3 were significantly higher in these infants than in the remaining twelve [median 2012 (786-2759) versus 42 (7-704), P<0.001]. In four infants PDA was treated successfully (one surgically, three with non-steroidal anti-inflammatory drugs). Two had haemodynamically insignificant closing ducts. In these infants with therapeutic or spontaneous resolution of a PDA, plasma BNP fell to normal values [median after treatment 9 pg/ml (8-27)]. Early measurement of plasma BNP in the first few days of life is a useful method for predicting those preterm infants who may require intervention for PDA.
authors.affiliation: Regional Neonatal Unit, St George's Hospital Medical School, Cranmer Terrace, London SW17 0RE, UK.
authors.forename: V F
authors.initials: VF
authors.lastname: Puddy
authors.forename: C
authors.initials: C
authors.lastname: Amirmansour
authors.forename: A F
authors.initials: AF
authors.lastname: Williams
authors.forename: D R J
authors.initials: DR
authors.lastname: Singer
mesh_terms: D015415:Biomarkers / Q000097:blood; D004374:Ductus Arteriosus, Patent / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain