Cardiovascular biomarkers in the evaluation of patent ductus arteriosus in very preterm neonates: A cohort study.

Autor: Sellmer A; Department of Cardiothoracic Surgery, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark; Perinatal Epidemiology Research Unit, Department of Pediatrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark. Electronic address: anna.sellmer@clin.au.dk., Hjortdal VE; Department of Cardiothoracic Surgery, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark. Electronic address: vibeke.hjortdal@regionh.dk., Bjerre JV; Department of Pediatrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark. Electronic address: jesper.bjerre@skejby.rm.dk., Schmidt MR; Department of Cardiology, Rishospitalet Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark. Electronic address: michael.rahbek.schmidt@regionh.dk., Bech BH; Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus, Denmark. Electronic address: bhb@ph.au.dk., Henriksen TB; Perinatal Epidemiology Research Unit, Department of Pediatrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark; Department of Pediatrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark. Electronic address: tine.brink.henriksen@clin.au.dk.
Jazyk: angličtina
Zdroj: Early human development [Early Hum Dev] 2020 Oct; Vol. 149, pp. 105142. Date of Electronic Publication: 2020 Aug 01.
DOI: 10.1016/j.earlhumdev.2020.105142
Abstrakt: Background: The evaluation of the patent ductus arteriosus (PDA) in the very premature neonate is a challenge. Echocardiography provides an interpretation of the hemodynamic condition. It is however, only a snapshot. Biomarkers may represent a physiological response to the hemodynamic alterations brought on by the PDA and may add to the identification of the clinical significant PDA.
Aim: To investigate the association between mid regional proadrenomodulin (MR-proADM), N-terminal pro b-type natriuretic peptide (NT-proBNP), mid regional pro-atrial natriuretic peptide (MR-proANP), C-terminal pro endothelin-1 (CT-proET1) and copeptin and echocardiographic measures of PDA.
Study Design: Cohort study with echocardiography performed on day 3 and 6. Blood samples from day 3.
Subject: 139 consecutive neonates born at a gestational age <32 weeks.
Outcome Measures: The main outcomes were presence of a PDA day 3 and 6, PDA diameter, left atrium to aorta ratio (LA:Ao-ratio), and descending aorta diastolic flow (DADF).
Results: Adjusted plasma levels of all investigated biomarkers, except CT-proET1, were found to be associated with both PDA diameter and LA:Ao-ratio, and also the presence of a large PDA. CT-proET1 and copeptin was found to be associated with abnormal DADF. Using pre-specified cut-off values NT-proBNP and MR-proANP day 3 seemed to be of value in identifying a large PDA day 3 and 6 in very preterm neonates.
Conclusion: Among the investigated biomarkers NT-proBNP and MR-proANP performed best in relation to echocardiographic markers of PDA severity in very preterm neonates.
Competing Interests: Declaration of competing interest The authors of this manuscript have none.
(Copyright © 2020 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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