title: A Clinical Study of the N-Terminal pro-Brain Natriuretic Peptide in Myocardial Injury after Neonatal Asphyxia.
abstract: BACKGROUND
  We aimed to study the changes of serum N-terminal pro-brain natriuretic to peptide (NT-proBNP) levels after asphyxia-induced myocardial injury in children and explore the relationship between serum NT-proBNP levels and neonatal asphyxia.
  
  
  METHODS
  One hundred and six cases of neonatal asphyxia were randomly selected for the study, including 46 severe cases with myocardial injury and 60 mild cases with no cardiac injury. Sixty-three healthy newborns were selected as the control group. The serum NT-proBNP level was detected using electrochemiluminescence. Creatine kinase MB (CK-MB) and serum sodium and calcium were measured simultaneously.
  
  
  RESULTS
  The serum NT-proBNP level in the myocardial injury group was significantly higher than that of the noncardiac injury and control groups (p < 0.01). Asphyxia serum NT-proBNP and cardiac enzymes were significantly correlated. The median value of neonatal NT-proBNP was 1491 pg/mL at postnatal Day 3 (P3) and 1077 pg/mL at postnatal Day 14 (P14). The cutoff value for children with myocardial injury was 3612.5 pg/mL; the area under the receiver operating characteristic curve was 0.80 (p < 0.001), with a sensitivity of 83.3%, a specificity of 80.5%, a positive predictive value of 82.8%, and a negative predictive value of 79.4%. After treatment, the serum NT-proBNP level in children with myocardial damage showed a significant decrease.
  
  
  CONCLUSIONS
  The serum NT-proBNP level can reflect myocardial injury in neonates with asphyxia and can guide its diagnosis.
authors.affiliation: Department of Pediatrics, Zhongnan Hospital of Wuhan University, Hubei 430071, China. Electronic address: ruizhu.wuhan@gmail.com.
authors.forename: Rui
authors.initials: R
authors.lastname: Zhu
authors.affiliation: Department of Epidemiology, School of Public Health, Wuhan University, Hubei 430071, China.
authors.forename: Zhenhong
authors.initials: Z
authors.lastname: Nie
mesh_terms: D001238:Asphyxia Neonatorum / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D006335:Heart Injuries / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: N-terminal pro-brain natriuretic peptide; NT-proBNP; brain natriuretic peptide; cardiac injury; neonatal asphyxia; neonates; perinatal care