title: Early echocardiographic prediction of ductal closure in neonates ≤ 30 weeks gestation.
abstract: OBJECTIVE
  To determine the accuracy of the patent ductus arteriosus:left pulmonary artery ratio (PDA:LPA) on echocardiogram (ECHO) at 3-day postnatal in predicting spontaneous PDA closure in neonates ≤ 30 weeks gestational age (GA).
  
  
  METHODS
  ECHOs were performed at 72 h to characterize PDA size as closed-to-small (PDA:LPA <0.5) or moderate-to-large (PDA:LPA ≥ 0.5) and at 10 days to determine spontaneous closure (defined as closed-to-small in the absence of medical and/or surgical treatment). Caretakers were blinded to results; treatment was based on standard care. Neonates were prospectively enrolled and stratified: <27 weeks (n=31) and 27 to 30 weeks (n=65).
  
  
  RESULTS
  Neonates <27 weeks with closed-to-small PDAs had 60% spontaneous closure vs 9% when moderate-to-large (positive predictive value (PPV) 60%, negative predictive value (NPV) 91%). Neonates 27 to 30 weeks had 95% spontaneous closure vs 27%, respectively (PPV 95%, NPV 73%). Inter-observer variability for the initial ECHO was 0.84.
  
  
  CONCLUSIONS
  PDA size defined by PDA:LPA at 3 days postnatal in combination with GA predicts spontaneous PDA closure.
authors.affiliation: Division of Cardiology, Department of Pediatrics, UT Southwestern Medical Center at Dallas, Children's Medical Center of Dallas, Dallas, TX 75235, USA.
authors.forename: P P
authors.initials: PP
authors.lastname: Thankavel
authors.forename: C R
authors.initials: CR
authors.lastname: Rosenfeld
authors.forename: L
authors.initials: L
authors.lastname: Christie
authors.forename: C
authors.initials: C
authors.lastname: Ramaciotti
mesh_terms: D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging*; D004452:Echocardiography; D005260:Female; D005865:Gestational Age; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging*; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D012075:Remission, Spontaneous; D012680:Sensitivity and Specificity