B-type Natriuretic Peptide: A Diagnostic Biomarker for a Hemodynamically Significant PDA

Authors

  • Hanan Zekri Department of Pediatrics, Cairo University, Giza, Egypt
  • Reem N. Said Department of Pediatrics, Cairo University, Giza, Egypt
  • Ranya A. Hegazy Department of Pediatrics, Cairo University, Giza, Egypt
  • Rania K. Darwish Department of Clinical Pathology, Cairo University, Giza, Egypt
  • Abdelkarim Kamel Department of Biochemistry, Cairo University, Giza, Egypt
  • Nahla Gamaleldin Abd El Hakim Department of Pediatrics, Cairo University, Giza, Egypt

DOI:

https://doi.org/10.3889/oamjms.2022.7139

Keywords:

Patent ductus arteriosus, Preterm infant, B-type natriuretic peptide, Echocardiogram

Abstract

Background: B-type natriuretic peptide (BNP) it has been reported to be a useful biomarker for the severity of hemodynamically significant patent ductus arteriosus (HsPDA) in premature infants. Objective: To assess serum levels of BNP in premature neonates with echocardiographically-confirmed hemodynamically significant and non-significant PDA (HnsPDA) and to explore the effect of PDA on left ventricular function. We also aimed to detect the level of BNP that differentiates between HsPDA and HnsPDA. Patients and methods: This was a cross-sectional observational study conducted on 73 randomly selected preterm neonates with HsPDA or hemodynamically nonsignificant PDA (HnsPDA), between May 2017 and May 2018. Echocardiography was done. BNP was measured using enzyme linked immunosorbent assay Results: There was no affection of left ventricular function in either group (LA/Ao ratio, FS, LVESD and LVEDD). PDA size, PFO size and PAP were significantly larger in HsPDA (p<0.001, p=0.001, p<0.001 respectively). Levels of BNP were significantly higher in HsPDA and correlated with the size of the PDA. At a cut-off value of 160.5 pg/ml, BNP had 80.49% sensitivity and 90.62% specificity with a positive predictive value of 91.7% and a negative predictive value of 78.04%, (AUC: 0.923, 95% C.I. 0.837 to 0.973). Conclusion: Levels of BNP in preterm babies with hemodynamically significant PDA rise early in neonatal life and correlate well with the size of the PDA. BNP can be used to screen for this condition. Ventricular dysfunction may not appear in the first 3 days of life.

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Published

2022-04-27

How to Cite

1.
Zekri H, Said RN, Hegazy RA, Darwish RK, Kamel A, El Hakim NGA. B-type Natriuretic Peptide: A Diagnostic Biomarker for a Hemodynamically Significant PDA. Open Access Maced J Med Sci [Internet]. 2022 Apr. 27 [cited 2024 Mar. 28];10(B):877-83. Available from: https://oamjms.eu/index.php/mjms/article/view/7139