title: Early signs that predict later haemodynamically significant patent ductus arteriosus.
abstract: OBJECTIVE
  Our aim was to determine the optimal cut-off values, sensitivity, specificity, and diagnostic power of 12 echocardiographic parameters on the second day of life to predict subsequent ductal patency.
  
  
  METHODS
  We evaluated preterm infants, born at ⩽32 weeks of gestation, starting on their second day of life, and they were evaluated every other day until ductal closure or until there were clinical signs of re-opening. We measured transductal diameter; pulmonary arterial diastolic flow; retrograde aortic diastolic flow; pulsatility index of the left pulmonary artery and descending aorta; left atrium and ventricle/aortic root ratio; left ventricular output; left ventricular flow velocity time integral; mitral early/late diastolic flow; and superior caval vein diameter and flow as well as performed receiver operating curve analysis.
  
  
  RESULTS
  Transductal diameter (>1.5 mm); pulmonary arterial diastolic flow (>25.6 cm/second); presence of retrograde aortic diastolic flow; ductal diameter by body weight (>1.07 mm/kg); left pulmonary arterial pulsatility index (⩽0.71); and left ventricle to aortic root ratio (>2.2) displayed high sensitivity and specificity (p0.9). Parameters with moderate sensitivity and specificity were as follows: left atrial to aortic root ratio; left ventricular output; left ventricular flow velocity time integral; and mitral early/late diastolic flow ratio (p0.05) had low diagnostic value.
  
  
  CONCLUSIONS
  Left pulmonary arterial pulsatility index, left ventricle/aortic root ratio, and ductal diameter by body weight are useful adjuncts offering a broader outlook for predicting ductal patency.
authors.affiliation: 1Department of Neonatology,Adnan Menderes University,Aydın,Turkey.
authors.forename: Defne
authors.initials: D
authors.lastname: Engür
authors.affiliation: 2Department of Pediatric Cardiology,Department of Pediatrics,Adnan Menderes University,Aydın,Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Deveci
authors.affiliation: 1Department of Neonatology,Adnan Menderes University,Aydın,Turkey.
authors.forename: Münevver K
authors.initials: MK
authors.lastname: Türkmen
mesh_terms: D001013:Aorta, Thoracic / Q000000981:diagnostic imaging*; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D018618:Echocardiography, Doppler, Color; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008297:Male; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000000981:diagnostic imaging*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D014421:Turkey
keywords: Echocardiography; neonatal intensive care unit; newborn; patent ductus arteriosus; receiver operating characteristic curve method