title: N-terminal-pro-B type natriuretic peptide as a useful tool to evaluate pulmonary hypertension and cardiac function in CDH infants.
abstract: OBJECTIVE
  In congenital diaphragmatic hernia (CDH) the severity of pulmonary hypertension (PH) is considered, by several authors, determinant of clinical outcome. Plasmatic N-terminal-pro-B type natriuretic peptide (NT-proBNP) might be useful in diagnosis and management of PH in newborns, although its interest in CDH infants remains to be defined. Early NT-proBNP levels were assessed in CDH infants and correlated with cardiovascular echocardiographic parameters.
  
  
  METHODS
  28 newborns, CDH and age-matched controls were enrolled in a prospective study. Clinical condition, NT-proBNP plasmatic levels, echo parameters of PH and biventricular function were assessed at 24 h after delivery as well as survival outcome.
  
  
  RESULTS
  Estimated mean pulmonary pressure and NT-proBNP were significantly higher in CDH than control infants. NT-proBNP significantly correlated with estimated pulmonary artery pressure, right ventricular Tei index, and tricuspid E/A ratio. Additionally, we found that CDH infants with NT-proBNP >11,500 pg/ml experienced a worse prognosis.
  
  
  CONCLUSIONS
  We demonstrated that PH is associated with NT-proBNP elevation and diastolic impairment in CDH infants. Early elevations in NT-proBNP levels seem to alert for a subset of CDH infants with worse prognosis.
authors.affiliation: Divisions of Pediatric Cardiology, Neonatology and Pediatric Surgery, Department of Pediatrics, Hospital S. João, Porto, Portugal. mjb@ecsaude.uminho.pt
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Baptista
authors.forename: Gustavo
authors.initials: G
authors.lastname: Rocha
authors.forename: Fátima
authors.initials: F
authors.lastname: Clemente
authors.forename: Luís F
authors.initials: LF
authors.lastname: Azevedo
authors.forename: Dick
authors.initials: D
authors.lastname: Tibboel
authors.forename: Adelino F
authors.initials: AF
authors.lastname: Leite-Moreira
authors.forename: Hercília
authors.initials: H
authors.lastname: Guimarães
authors.forename: José C
authors.initials: JC
authors.lastname: Areias
authors.forename: Jorge
authors.initials: J
authors.lastname: Correia-Pinto
mesh_terms: D001794:Blood Pressure / Q000502:physiology; D016022:Case-Control Studies; D004452:Echocardiography; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006548:Hernia, Diaphragmatic / Q000097:blood / Q000503:physiopathology*; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D006976:Hypertension, Pulmonary / Q000097:blood* / Q000175:diagnosis* / Q000503:physiopathology; D007231:Infant, Newborn; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain