title: Association of aortic stiffness to brain natriuretic peptide in children before and after device closure of patent ductus arteriosus.
abstract: OBJECTIVE
  We evaluated the influence of device closure for patent ductus arteriosus (PDA) on the aortic stiffness index (ASI) and brain natriuretic peptide (BNP) and their association with cardiac function.
  
  
  METHODS
  ASI and echocardiography assessment before and after treatment (16 ± 9 months) in 48 children with PDA (mean age 10 ± 4.5) and 52 control children (mean age 9.7 ± 4.6). BNP level was measured pre-closure for all children, and was measured six months after closure only for children with PDA.
  
  
  RESULTS
  ASI was higher in PDA patients than in controls (P < 0.001). ASI correlated with age (P < 0.05), LVEF% (P < 0.01), E/E' (<0.03), pulmonary artery pressure (P < 0.001), and BNP (P < 0.001). ASI and BNP significantly decreased after closure (P < 0.001). ASI and BNP were independent predictors for post-closure systolic dysfunction (P < 0.001and <0.005, respectively). Receiver operating curve (ROC) analysis showed that ASI ⩾ 13.5, BNP level ⩾75 pg/ml and basal mean pulmonary artery pressure (PAP) ⩾ 23 were powerful predictors for post-closure systolic function.
  
  
  CONCLUSIONS
  ASI is significantly associated with BNP and basal PAP in children with PDA. After device closure, aortic distensibility improved significantly and was associated with significant improvement in both systolic and diastolic functions. ASI can be used for monitoring the course of patients with PDA, and may give opportunities for early intervention.
authors.affiliation: Congenital Unit, Cardiology Department, Zagazig University Hospital, Egypt.
authors.forename: Ragab A
authors.initials: RA
authors.lastname: Mahfouz
authors.affiliation: Congenital Unit, Cardiology Department, Zagazig University Hospital, Egypt.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Alzaiat
authors.affiliation: Congenital Unit, Cardiology Department, Zagazig University Hospital, Egypt.
authors.forename: Marwa
authors.initials: M
authors.lastname: Gad
keywords: Aortic stiffness; Device closure; Patent ductus arteriosus