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NT-proBNP as an Early Marker of Diastolic Ventricular Dysfunction in Very-Low-Birth-Weight Infants

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Abstract

The objective is to examine the correlation between plasma levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) and tissue Doppler imaging (TDI) echocardiographic parameters in the first 28 days of life in very-low-birth-weight infants (VLBWI). VLBWI admitted to the Neonatal Intensive Care Unit (NICU) at Hospital Puerta del Mar, Spain, from January 2015 to January 2017 were prospectively enrolled. Weekly determination of plasma NT-proBNP (pg/mL), and echocardiograms were done during the first 28 days of life. 101 preterm infants with a mean GA of 28.85 weeks (± 1.85 SD) and mean birth weight of 1152 g (± 247.4 SD) were included. A total of 483 echocardiograms and 139 NT-proBNP determinations were performed. We found a negative correlation between plasma NT-proBNP levels and diastolic velocities: mitral A′ (ρ = − 0.15, p = 0.04), mitral E′ (ρ = − 0.17, p = 0.02), tricuspid A′ (ρ = − 0.20, p = 0.006), tricuspid E′ (ρ = − 0.24, p = 0.0009). In the first 24 h of life, NT-proBNP levels were strongly correlated with mitral A′ and E′ velocities in patients with no patent ductus arteriosus (PDA) (ρ = − 0.75, p = 0.04). In preterm patients, elevated NT-proBNP levels are related to worse diastolic myocardial function. In the first 24 h, this correlation is much stronger in the absence of PDA.

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Abbreviations

BNP:

B-type natriuretic peptide

EDTA:

Ethylenediaminetetraacetic acid

LV:

Left ventricle

MPI:

Myocardial performance index

NICU:

Neonatal Intensive Care Unit

NT-proBNP:

N-terminal pro-brain natriuretic peptide

PDA:

Patent ductus arteriosus

SD:

Standard deviation

SF:

Shortening fraction

TDI:

Tissue Doppler imaging

VLBWI:

Very-low-birth-weight infants

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Funding

The study was supported by University Hospital Puerta del Mar from Servicio Andaluz de Salud (Junta de Andalucía, Spain).

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Authors and Affiliations

  1. Department of Neonatology, “Puerta del Mar” University Hospital, Avda. Ana de Viya, 21, 11009, Cadiz, Spain

    Pamela Zafra-Rodríguez, Paula Méndez-Abad, Simón P. Lubián-López & Isabel Benavente-Fernández

Authors
  1. Pamela Zafra-Rodríguez
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  2. Paula Méndez-Abad
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  3. Simón P. Lubián-López
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  4. Isabel Benavente-Fernández
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Contributions

Substantial contributions to conception and design: PZ-R, PM-A, IB-F, SL-L. Acquisition of data: PZ-R, PM-A. Analysis and interpretation of data: PZ-R, PM-A, IB-F. Drafting the article: PZ-R, PM-A. Revising the article critically for important intellectual content: IB-F, SL-L. Final approval of the version to be published: PZ-R, PM-A, IB-F, SL-L.

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Correspondence to Pamela Zafra-Rodríguez.

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Zafra-Rodríguez, P., Méndez-Abad, P., Lubián-López, S.P. et al. NT-proBNP as an Early Marker of Diastolic Ventricular Dysfunction in Very-Low-Birth-Weight Infants. Pediatr Cardiol 40, 1165–1170 (2019). https://doi.org/10.1007/s00246-019-02125-z

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  • DOI: https://doi.org/10.1007/s00246-019-02125-z

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