title: Aminoterminal B-type natriuretic peptide (NT-proBNP) in the therapy of patent ductus arteriosus.
abstract: BACKGROUND
  NT-proBNP is a reliable index in case of cardiac diseases.
  
  
  OBJECTIVE
  To evaluate the diagnostic usefulness of NT-proBNP as index of the closure of patent ductus arteriosus (PDA) in ELBW.
  
  
  METHODS
  Considered 73 ELBW (mGA 26+3 weeks; mBW 789 g) with echocardiographical diagnosis of PDA. The closure of the duct was spontaneous in 22%, pharmacological in 49.3% and by surgical ligation in 28.7%. Plasma NT-proBNP levels were measured on day 3 in 35 preterm infants; in 20 of them concentrations of the peptide were assayed on day 3 and on closure of the duct.
  
  
  RESULTS
  On day 3 the median of NT-proBNP levels was 13718 pg/ml (range 1918-70000). Peptide concentrations did not differ between pharmacological treatment and surgical ligation (respectively 13718 and 12342 pg/ml; p = 0.33). Concentrations of NT-proBNP were significantly lower on the closure of the duct (p < 0.0001) compared to concentrations on day 3 (median 12666 at day 3 versus 2443.5 pg/ml at closure), with a decrease of 80.71%.
  
  
  CONCLUSIONS
  ELBW showed high variability of NT-proBNP concentrations both on day 3 and on closure of PDA. Although NT-proBNP high levels were indicative of the presence of hsPDA, due to the extreme heterogeneity of the values it was not possible to determine an absolute cut-off concentration of NT-proBNP below which closure of the duct occurred, while a decrease of NT-proBNP > or =80% was a reliable index of PDA closure.
authors.affiliation: Department of Pediatrics, Obstetrics and Reproduction Medicine, Neonatal Intensive Care, University of Siena, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Bagnoli
authors.forename: A
authors.initials: A
authors.lastname: Rossetti
authors.forename: M
authors.initials: M
authors.lastname: Casucci
authors.forename: A
authors.initials: A
authors.lastname: Mori
mesh_terms: D015415:Biomarkers; D004374:Ductus Arteriosus, Patent / Q000097:blood* / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D005260:Female; D005865:Gestational Age; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000097:blood* / Q000188:drug therapy / Q000601:surgery; D008026:Ligation; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D012075:Remission, Spontaneous; D051437:Renal Insufficiency / Q000150:complications; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D007052:Ibuprofen