How useful are B-type natriuretic peptide measurements for monitoring changes in patent ductus arteriosus shunt magnitude?
OBJECTIVE
Although B-type natriuretic peptide (BNP) concentrations seem to be useful for detecting the presence of patent ductus arteriosus, there is no information about their usefulness for monitoring changes in PDA shunt magnitude.


METHODS
We performed a retrospective analysis of paired BNP-echocardiogram measurements (obtained from infants (24 to 32 weeks gestation) with clinical suspicion of PDA).


RESULTS
Individual BNP concentrations (n=146, from 88 infants) were significantly related to shunt magnitude at the time of measurement and had good discriminating power for detecting a moderate-or-large shunt (area under receiver-operator characteristic curves (ROC-AUC)=0.85). In total, 36 infants had serial BNP-echocardiogram pairs (n=91) measured during their hospitalization. Changes (either increases or decreases) in BNP concentrations over time had only fair discriminating power (ROC-AUC=0.76) for detecting increases or decreases, respectively, in shunt magnitude.


CONCLUSIONS
The high degree of variability in the BNP measurements made them less useful for monitoring changes in magnitude.
Chen
S
S
Department of Pediatrics, University of California-San Francisco, 513 Parnassus Ave., San Francisco, CA 94143-0544, USA.
Tacy
T
T
Clyman
R
R
D002317:Cardiovascular Agents / Q000627:therapeutic use; D004374:Ductus Arteriosus, Patent / Q000097:blood* / Q000175:diagnosis* / Q000188:drug therapy; D004452:Echocardiography; D005260:Female; D005865:Gestational Age; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000097:blood* / Q000188:drug therapy*; D019102:Infant, Very Low Birth Weight; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011237:Predictive Value of Tests
D002317:Cardiovascular Agents; D020097:Natriuretic Peptide, Brain; D007213:Indomethacin