title: BNP, troponin I, and YKL-40 as screening markers in extremely preterm infants at risk for pulmonary hypertension associated with bronchopulmonary dysplasia.
abstract: Bronchopulmonary dysplasia (BPD) is often complicated by pulmonary hypertension (PH). We investigated three biomarkers potentially suitable as screening markers for extremely preterm infants at risk of BPD-associated PH. In this prospective observational cohort study conducted in a tertiary neonatal intensive care unit, 83 preterm infants with BPD born <28-wk gestation and still inpatients at 36-wk corrected age received an echocardiogram and blood tests of B-type natriuretic peptide (BNP), troponin I, and YKL-40. Infants were analyzed according to echocardiographic evidence of tricuspid regurgitation (TR). Thirty infants had evidence of TR on echocardiogram at 36-wk corrected age. Infants with or without TR had similar baseline demographics: mean ± SD gestational age 261± 12vs. 261± 11wk and birth weight 830 ± 206 vs. 815 ± 187 g, respectively. There was no difference in duration of respiratory support. The right ventricular systolic pressure of infants with evidence of TR was 40 ± 16 mmHg. BNP was the only biomarker that proved to be significantly higher in infants with evidence of TR: median (interquartile range) serum level 54.5 (35-105) vs. 41.5 (30-59) pg/ml, P = 0.043. Subgroup analysis of infants with severe BPD requiring discharge on home oxygen or BPD-related mortality revealed similar results. There was no difference between groups for troponin I and YKL-40. In conclusion, increased serum levels of BNP were associated with evidence of TR at 36-wk corrected gestational age in extremely preterm infants, suggesting a potential role as a screening biomarker for BPD-associated PH.
authors.affiliation: Mercy Hospital for Women, Department of Paediatrics, Melbourne, Victoria, Australia; kaikonig@gmail.com.
authors.forename: Kai
authors.identifier: 0000-0003-1876-9806
authors.initials: K
authors.lastname: König
authors.affiliation: Mercy Hospital for Women, Department of Paediatrics, Melbourne, Victoria, Australia.
authors.forename: Katelyn J
authors.initials: KJ
authors.lastname: Guy
authors.affiliation: Ritchie Centre, Hudson Institute of Medical Research, Clayton, Victoria, Australia; and.|Department of Paediatrics, Monash University, Clayton, Victoria, Australia.
authors.forename: Claudia A
authors.initials: CA
authors.lastname: Nold-Petry
authors.affiliation: Mercy Hospital for Women, Department of Paediatrics, Melbourne, Victoria, Australia.
authors.forename: Charles P
authors.initials: CP
authors.lastname: Barfield
authors.affiliation: Mercy Hospital for Women, Department of Paediatrics, Melbourne, Victoria, Australia.
authors.forename: Geraldine
authors.initials: G
authors.lastname: Walsh
authors.affiliation: Mercy Hospital for Women, Department of Paediatrics, Melbourne, Victoria, Australia.
authors.forename: Sandra M
authors.initials: SM
authors.lastname: Drew
authors.affiliation: Ritchie Centre, Hudson Institute of Medical Research, Clayton, Victoria, Australia; and.|Department of Paediatrics, Monash University, Clayton, Victoria, Australia.
authors.forename: Alex
authors.initials: A
authors.lastname: Veldman
authors.affiliation: Ritchie Centre, Hudson Institute of Medical Research, Clayton, Victoria, Australia; and.|Department of Paediatrics, Monash University, Clayton, Victoria, Australia.
authors.forename: Marcel F
authors.initials: MF
authors.lastname: Nold
authors.affiliation: Mercy Hospital for Women, Department of Paediatrics, Melbourne, Victoria, Australia.
authors.forename: Dan M
authors.initials: DM
authors.lastname: Casalaz
mesh_terms: D015415:Biomarkers / Q000097:blood; D001997:Bronchopulmonary Dysplasia / Q000097:blood* / Q000150:complications; D000071451:Chitinase-3-Like Protein 1 / Q000097:blood*; D003710:Demography; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000097:blood* / Q000150:complications; D062071:Infant, Extremely Premature / Q000097:blood*; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D012123:Pulmonary Ventilation; D012307:Risk Factors; D019210:Troponin I / Q000097:blood*
chemical_list: D015415:Biomarkers; C084533:CHI3L1 protein, human; D000071451:Chitinase-3-Like Protein 1; D019210:Troponin I; D020097:Natriuretic Peptide, Brain
keywords: B-type natriuretic peptide; biomarker; bronchopulmonary dysplasia; preterm infants; pulmonary hypertension