title: Correlation analysis between echocardiographic flow pattern and N-terminal-pro-brain natriuretic peptide for early targeted treatment of patent ductus arteriosus.
abstract: OBJECTIVE
  Echocardiographic flow patterns of patent ductus arteriosus (PDA) are useful to predict the development of hemodynamically significant ductus in premature infants. N-terminal pro-brain natriuretic peptide (NT-proBNP) concentrations seem to be useful to detect PDA. We investigated how NT-proBNP levels change on the basis of different flow patterns during the first day of life, and whether NT-proBNP might represent a reliable decision tool in PDA management.
  
  
  METHODS
  Neonates with gestational age <32 weeks were assessed prospectively, using paired Doppler-echocardiographic evaluation and NT-proBNP values, at T0 (6-24 h of life), and daily until ductal closure.
  
  
  RESULTS
  At T0, NT-proBNP concentrations of 41 neonates correlated to the kind of pattern (p = 0.018) with the highest values in neonates with pulsatile or growing patterns. A value <9854 pg/ml identified neonates with spontaneous closure (sensitivity 71.8%, specificity 100%). Overall, 32 infants needed treatment. Pre-treatment NT-proBNP values increased compared to those at T0, significantly in neonates with growing pattern at T0 (p = 0.001). After treatment, NT-proBNP concentrations decreased compared to pre-treatment values (p = 0.0024), more markedly in the responders than in the non-responders (p = 0.042).
  
  
  CONCLUSIONS
  NT-proBNP concentrations at T0 show a good agreement with different flow patterns and represent a useful tool to identify neonates at risk of developing hemodynamically significant PDA.
authors.affiliation: Division of Neonatology and.
authors.forename: Federica
authors.initials: F
authors.lastname: Occhipinti
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: De Carolis
authors.forename: Gabriella
authors.initials: G
authors.lastname: De Rosa
authors.forename: Iliana
authors.initials: I
authors.lastname: Bersani
authors.forename: Serafina
authors.initials: S
authors.lastname: Lacerenza
authors.forename: Francesco
authors.initials: F
authors.lastname: Cota
authors.forename: Serena Antonia
authors.initials: SA
authors.lastname: Rubortone
authors.forename: Costantino
authors.initials: C
authors.lastname: Romagnoli
mesh_terms: D015415:Biomarkers / Q000032:analysis / Q000097:blood; D052246:Cyclooxygenase 2 Inhibitors / Q000008:administration & dosage; D016903:Drug Monitoring / Q000379:methods; D004374:Ductus Arteriosus, Patent / Q000097:blood* / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000401:mortality; D061345:Early Medical Intervention / Q000379:methods; D018618:Echocardiography, Doppler, Color; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D058990:Molecular Targeted Therapy; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D012039:Regional Blood Flow; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D052246:Cyclooxygenase 2 Inhibitors; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: B-type natriuretic peptide; Doppler flow pattern; echocardiography; patent ductus arteriosus; premature neonate