Early N-Terminal Pro B-Type Natriuretic Peptide (NTproBNP) Plasma Values and Associations with Patent Ductus Arteriosus Closure and Treatment—An Echocardiography Study of Extremely Preterm Infants
The aim was to investigate the association of gestational age (GA), echocardiographic markers and levels of plasma N-terminal pro-B-type natriuretic peptide (NTproBNP) with the closure rate of a haemodynamically significant patent ductus arteriosus (hsPDA). Ninety-eight Swedish extremely preterm inf...
Main Authors: | , , , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
MDPI AG
2022-01-01
|
Series: | Journal of Clinical Medicine |
Subjects: | |
Online Access: | https://www.mdpi.com/2077-0383/11/3/667 |
_version_ | 1797487000197005312 |
---|---|
author | Anna Gudmundsdottir Marco Bartocci Oda Picard Joanna Ekström Alexander Chakhunashvili Kajsa Bohlin Caroline Attner Gordana Printz Mathias Karlsson Lilly-Ann Mohlkert Jonna Karlén Cecilia Pegelow Halvorsen Anna-Karin Edstedt Bonamy |
author_facet | Anna Gudmundsdottir Marco Bartocci Oda Picard Joanna Ekström Alexander Chakhunashvili Kajsa Bohlin Caroline Attner Gordana Printz Mathias Karlsson Lilly-Ann Mohlkert Jonna Karlén Cecilia Pegelow Halvorsen Anna-Karin Edstedt Bonamy |
author_sort | Anna Gudmundsdottir |
collection | DOAJ |
description | The aim was to investigate the association of gestational age (GA), echocardiographic markers and levels of plasma N-terminal pro-B-type natriuretic peptide (NTproBNP) with the closure rate of a haemodynamically significant patent ductus arteriosus (hsPDA). Ninety-eight Swedish extremely preterm infants, mean GA 25.7 weeks (standard deviation 1.3), born in 2012–2014, were assessed with echocardiography and for levels of NTproBNP. Thirty-three (34%) infants had spontaneous ductal closure within three weeks of age. Infants having spontaneous closure at seven days or less had significantly lower NTproBNP levels on day three, median 1810 ng/L (IQR 1760–6000 ng/L) compared with: infants closing spontaneously later, 10,900 ng/L (6120–19,200 ng/L); infants treated either with ibuprofen only, 14,600 ng/L (7740–28,100 ng/L); or surgery, 32,300 ng/L (29,100–35,000 ng/L). Infants receiving PDA surgery later had significantly higher NTproBNP values on day three than other infants. Day three NTproBNP cut-off values of 15,001–18,000 ng/L, predicted later PDA surgery, with an area under the curve in ROC analysis of 0.69 (0.54–0.83). In conclusion, the spontaneous PDA closure rate is relatively high in extremely preterm infants. Early NTproBNP levels can be used with GA in the management decisions of hsPDA. |
first_indexed | 2024-03-09T23:41:22Z |
format | Article |
id | doaj.art-e9f030570f3b450ca17eae3387667a17 |
institution | Directory Open Access Journal |
issn | 2077-0383 |
language | English |
last_indexed | 2024-03-09T23:41:22Z |
publishDate | 2022-01-01 |
publisher | MDPI AG |
record_format | Article |
series | Journal of Clinical Medicine |
spelling | doaj.art-e9f030570f3b450ca17eae3387667a172023-11-23T16:52:09ZengMDPI AGJournal of Clinical Medicine2077-03832022-01-0111366710.3390/jcm11030667Early N-Terminal Pro B-Type Natriuretic Peptide (NTproBNP) Plasma Values and Associations with Patent Ductus Arteriosus Closure and Treatment—An Echocardiography Study of Extremely Preterm InfantsAnna Gudmundsdottir0Marco Bartocci1Oda Picard2Joanna Ekström3Alexander Chakhunashvili4Kajsa Bohlin5Caroline Attner6Gordana Printz7Mathias Karlsson8Lilly-Ann Mohlkert9Jonna Karlén10Cecilia Pegelow Halvorsen11Anna-Karin Edstedt Bonamy12Department of Women’s and Children’s Health, Karolinska Institutet, 171 77 Stockholm, SwedenDepartment of Women’s and Children’s Health, Karolinska Institutet, 171 77 Stockholm, SwedenDepartment of Women’s and Children’s Health, Karolinska Institutet, 171 77 Stockholm, SwedenEmergency Paediatric Emergency Medicine, Children’s Minnesota, Minneapolis, MN 55404, USADepartment of IT Development and Healthcare Information Systems, Karolinska University Hospital, 171 64 Stockholm, SwedenDepartment of Neonatology, Astrid Lindgren Children’s Hospital, Karolinska University Hospital, 171 64 Stockholm, SwedenSachs’ Children and Youth Hospital, Södersjukhuset, 118 83 Stockholm, SwedenDepartment of Women’s and Children’s Health, Karolinska Institutet, 171 77 Stockholm, SwedenClinical Research Center and Department of Clinical Chemistry, Central Hospital, 652 30 Karlstad, SwedenDepartment of Clinical Science, Intervention and Technology, Karolinska Institutet, 171 77 Stockholm, SwedenSachs’ Children and Youth Hospital, Södersjukhuset, 118 83 Stockholm, SwedenSachs’ Children and Youth Hospital, Södersjukhuset, 118 83 Stockholm, SwedenClinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, 171 77 Stockholm, SwedenThe aim was to investigate the association of gestational age (GA), echocardiographic markers and levels of plasma N-terminal pro-B-type natriuretic peptide (NTproBNP) with the closure rate of a haemodynamically significant patent ductus arteriosus (hsPDA). Ninety-eight Swedish extremely preterm infants, mean GA 25.7 weeks (standard deviation 1.3), born in 2012–2014, were assessed with echocardiography and for levels of NTproBNP. Thirty-three (34%) infants had spontaneous ductal closure within three weeks of age. Infants having spontaneous closure at seven days or less had significantly lower NTproBNP levels on day three, median 1810 ng/L (IQR 1760–6000 ng/L) compared with: infants closing spontaneously later, 10,900 ng/L (6120–19,200 ng/L); infants treated either with ibuprofen only, 14,600 ng/L (7740–28,100 ng/L); or surgery, 32,300 ng/L (29,100–35,000 ng/L). Infants receiving PDA surgery later had significantly higher NTproBNP values on day three than other infants. Day three NTproBNP cut-off values of 15,001–18,000 ng/L, predicted later PDA surgery, with an area under the curve in ROC analysis of 0.69 (0.54–0.83). In conclusion, the spontaneous PDA closure rate is relatively high in extremely preterm infants. Early NTproBNP levels can be used with GA in the management decisions of hsPDA.https://www.mdpi.com/2077-0383/11/3/667cardiac troponin Techocardiographyextremely pretermN-terminal pro B-type natriuretic peptidepatent ductus arteriosus |
spellingShingle | Anna Gudmundsdottir Marco Bartocci Oda Picard Joanna Ekström Alexander Chakhunashvili Kajsa Bohlin Caroline Attner Gordana Printz Mathias Karlsson Lilly-Ann Mohlkert Jonna Karlén Cecilia Pegelow Halvorsen Anna-Karin Edstedt Bonamy Early N-Terminal Pro B-Type Natriuretic Peptide (NTproBNP) Plasma Values and Associations with Patent Ductus Arteriosus Closure and Treatment—An Echocardiography Study of Extremely Preterm Infants Journal of Clinical Medicine cardiac troponin T echocardiography extremely preterm N-terminal pro B-type natriuretic peptide patent ductus arteriosus |
title | Early N-Terminal Pro B-Type Natriuretic Peptide (NTproBNP) Plasma Values and Associations with Patent Ductus Arteriosus Closure and Treatment—An Echocardiography Study of Extremely Preterm Infants |
title_full | Early N-Terminal Pro B-Type Natriuretic Peptide (NTproBNP) Plasma Values and Associations with Patent Ductus Arteriosus Closure and Treatment—An Echocardiography Study of Extremely Preterm Infants |
title_fullStr | Early N-Terminal Pro B-Type Natriuretic Peptide (NTproBNP) Plasma Values and Associations with Patent Ductus Arteriosus Closure and Treatment—An Echocardiography Study of Extremely Preterm Infants |
title_full_unstemmed | Early N-Terminal Pro B-Type Natriuretic Peptide (NTproBNP) Plasma Values and Associations with Patent Ductus Arteriosus Closure and Treatment—An Echocardiography Study of Extremely Preterm Infants |
title_short | Early N-Terminal Pro B-Type Natriuretic Peptide (NTproBNP) Plasma Values and Associations with Patent Ductus Arteriosus Closure and Treatment—An Echocardiography Study of Extremely Preterm Infants |
title_sort | early n terminal pro b type natriuretic peptide ntprobnp plasma values and associations with patent ductus arteriosus closure and treatment an echocardiography study of extremely preterm infants |
topic | cardiac troponin T echocardiography extremely preterm N-terminal pro B-type natriuretic peptide patent ductus arteriosus |
url | https://www.mdpi.com/2077-0383/11/3/667 |
work_keys_str_mv | AT annagudmundsdottir earlynterminalprobtypenatriureticpeptidentprobnpplasmavaluesandassociationswithpatentductusarteriosusclosureandtreatmentanechocardiographystudyofextremelypreterminfants AT marcobartocci earlynterminalprobtypenatriureticpeptidentprobnpplasmavaluesandassociationswithpatentductusarteriosusclosureandtreatmentanechocardiographystudyofextremelypreterminfants AT odapicard earlynterminalprobtypenatriureticpeptidentprobnpplasmavaluesandassociationswithpatentductusarteriosusclosureandtreatmentanechocardiographystudyofextremelypreterminfants AT joannaekstrom earlynterminalprobtypenatriureticpeptidentprobnpplasmavaluesandassociationswithpatentductusarteriosusclosureandtreatmentanechocardiographystudyofextremelypreterminfants AT alexanderchakhunashvili earlynterminalprobtypenatriureticpeptidentprobnpplasmavaluesandassociationswithpatentductusarteriosusclosureandtreatmentanechocardiographystudyofextremelypreterminfants AT kajsabohlin earlynterminalprobtypenatriureticpeptidentprobnpplasmavaluesandassociationswithpatentductusarteriosusclosureandtreatmentanechocardiographystudyofextremelypreterminfants AT carolineattner earlynterminalprobtypenatriureticpeptidentprobnpplasmavaluesandassociationswithpatentductusarteriosusclosureandtreatmentanechocardiographystudyofextremelypreterminfants AT gordanaprintz earlynterminalprobtypenatriureticpeptidentprobnpplasmavaluesandassociationswithpatentductusarteriosusclosureandtreatmentanechocardiographystudyofextremelypreterminfants AT mathiaskarlsson earlynterminalprobtypenatriureticpeptidentprobnpplasmavaluesandassociationswithpatentductusarteriosusclosureandtreatmentanechocardiographystudyofextremelypreterminfants AT lillyannmohlkert earlynterminalprobtypenatriureticpeptidentprobnpplasmavaluesandassociationswithpatentductusarteriosusclosureandtreatmentanechocardiographystudyofextremelypreterminfants AT jonnakarlen earlynterminalprobtypenatriureticpeptidentprobnpplasmavaluesandassociationswithpatentductusarteriosusclosureandtreatmentanechocardiographystudyofextremelypreterminfants AT ceciliapegelowhalvorsen earlynterminalprobtypenatriureticpeptidentprobnpplasmavaluesandassociationswithpatentductusarteriosusclosureandtreatmentanechocardiographystudyofextremelypreterminfants AT annakarinedstedtbonamy earlynterminalprobtypenatriureticpeptidentprobnpplasmavaluesandassociationswithpatentductusarteriosusclosureandtreatmentanechocardiographystudyofextremelypreterminfants |