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ORIGINAL ARTICLE
Year : 2016  |  Volume : 5  |  Issue : 3  |  Page : 143-149

Gestational and postnatal age influence B-type natriuretic peptide level used in diagnosis of a hemodynamically significant patent ductus arteriosus in preterm infants


1 Department of Pediatrics, Albany Medical Center, Albany, NY 12208, USA
2 Capital District Pediatric Cardiology Associates, Albany, NY 12208, USA

Correspondence Address:
Dr. Kate A Tauber
Albany Medical Center, Bernard and Millie Duker Children's Hospital, 47, New Scotland Avenue, MC101, Albany, NY 12208
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2249-4847.191241

Clinical trial registration NCT01497054

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Objective: To determine a cutoff value for B-type natriuretic peptide (BNP) level above which suggests a hemodynamically significant patent ductus arteriosus (hsPDA) and evaluate whether gestational age influences BNP production. Subjects and Methods: This was a prospective, observational study on infants of 24 0/7-31 6/7 weeks gestation. Up to 5 BNP levels were drawn within the first 2 weeks of life. An echocardiogram was done within the first 5 days in conjunction with the second BNP level. A patent ductus arteriosus (PDA) was graded as no, nonsignificant, or hemodynamically significant. Kruskal-Wallis test and Mann-Whitney U-test were used for statistical analyses. Result: There were 135 BNP-echocardiogram pairs in 95 patients. BNP levels were significantly different between PDA groups, P < 0.0001. Based on our receiver operating characteristic curve, a BNP level of 276 pg/ml or above on the day of life (DOL) 5 was suggestive of an hsPDA. Gestational age had a significant effect on BNP production. Conclusion: A cutoff BNP level of 276 pg/ml on DOL 5 is suggestive of an hsPDA in preterm infants of <32 weeks gestation. Gestational age has a significant impact on the ability of a preterm infant to produce BNP in response to an hsPDA, and therefore, different cutoff values based on gestational age may be appropriate.


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