N-terminal pro-brain natriuretic peptide as a predictor of hemodynamic significance of functioning ductus arteriosus in premature newborns

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Abstract

Objective. To study the possibility of using N-terminal pro-BNP fragment as a screening criterion of hemodynamic significant of the functioning arterial duct in extremely premature newborns. Hemodynamically significant functioning arterial duct (HSFAD) is a reason of the development of various complications in extremely premature newborns. The basic method for HSFAD diagnosis is Echo CG. The limited technical abilities of ultrasound devices can prevent from an early diagnosis and timely treatment of this state. The search of additional markers of hemodynamic significance the functioning arterial duct (FAD) is actual.

Materials and methods. A continuous prospective observational study included patients aged 1 to 3 days with FAD, gestation period of 25–32 weeks and birth weight from 500 to 1500 g. Hemodynamic significance of FAD was determined according to generally accepted Eco CG criteria. The level of NT-pro-BNP was identified with IFA on the third day of life. Mathematical modelling was used to calculate a “threshold” value of NT-pro-BNP, corresponding to 6500 pg/ml, at which the probability of hemodynamic significance of the functioning arterial duct exceeds 80 %.

Results. The assessment of NT-pro BNP concentration on the third day of life permitted to establish the following reliable differences: in the main group, the median concentration for NT-pro BNP was 15000 [IQR 2 587; 26 500] pg/ml, in the comparison group – 1920 [IQR 1379; 3467] pg/ml, р = 0.001. Mean force direct correlation, r = 0.52, between Echo CG results and NT-pro-BNP values was stated.

Conclusions. The obtained results make it possible to use NT-pro-BNP as a screening criterion of FAD hemodynamic significance in extremely premature newborns.

About the authors

Artem A. Porodikov

Sukhanov Federal Center for Cardiovascular Surgery

Author for correspondence.
Email: porodickov.a@yandex.ru
ORCID iD: 0000-0003-3624-3226

cardiovascular surgeon

Russian Federation, Perm

Alexey N. Biyanov

E.A. Vagner Perm State Medical University

Email: big-1279@yandex.ru
ORCID iD: 0000-0002-9314-3558

Candidate of Medical Sciences, Associate Professor, Department of Pediatrics with Course of Polyclinic Pediatrics

Russian Federation, Perm

Anna V. Permyakova

E.A. Vagner Perm State Medical University

Email: derucheva@mail.ru
ORCID iD: 0000-0001-5189-0347

Candidate of Medical Sciences, Associate Professor, Department of Pediatric Infectious Diseases

Russian Federation, Perm

Vadim S. Tuktamyshev

Perm National Research Polytechnic University

Email: helpinvader@list.ru
ORCID iD: 0000-0002-3994-0388

Candidate of Physical and Mathematical Sciences, Associate Professor, Department of Calculus Mathematics, Mechanics and Biomechanics, researcher of KFU

Russian Federation, Perm

Aleksey G. Kuchumov

Perm National Research Polytechnic University

Email: kychymov@inbox.ru
ORCID iD: 0000-0002-0466-175X

Candidate of Physical and Mathematical Sciences, Associate Professor, Department of Calculus Mathematics, Mechanics and Biomechanics, researcher of KFU

Russian Federation, Perm

Natalia S. Pospelova

E.A. Vagner Perm State Medical University

Email: kulikalova@mail.ru
ORCID iD: 0000-0003-0075-0226

Candidate of Medical Sciences, Associate Professor, Department of Pediatric Infectious Diseases

Russian Federation, Perm

Evgeny G. Furman

E.A. Vagner Perm State Medical University

Email: furman1@yandex.ru
ORCID iD: 0000-0002-1751-5532

Corresponding Member of RAS, MD, PhD, Professor, Deputy Rector for Scientific Research, Head of Department of Faculty Pediatrics

Russian Federation, Perm

M. N. Onoprienko

Perm Regional Perinatal Center

Email: porodickov.a@yandex.ru

anesthesiologist-resuscitator, ICU of Newborn and Premature Infants

Russian Federation, Perm

References

  1. Hannah Blencowe, Simon Cousens, Doris Chou, Mikkel Oestergaard, Lale Say, Anneth Moller, Mary Kinney, Joy Lawn. Born too soon: the global epidemiology of 15 million preterm births. Reprod Health 2013; 10 (1): 2.
  2. Prahov A.V., Gaponenko V.A., Ignashina E.G. Diseases of the heart of the fetus and newborn baby. Series: Neonatal Cardiology. N. Novgorod: Izd-vo Nizhegorodskoy gos. med. Akademii 2001; 188 (in Russian).
  3. Volyanyuk E.V. Hemodynamically significant patent ductus arteriosus in premature newborns. Prakticheskaya meditsina 2010; 5: 73–75 (in Russian).
  4. Kryuchko D.S., Baybarina E.N., Rudakova A.A. Open arterial duct in premature newborn: tactics of neonatologist. Voprosy sovremennoi pediatrii 2011; 10 (1): 58–65 (in Russian).
  5. Vinogradova I.V., Krasnova M.V. Optimization of nursing of extremely low and very low birth weight infants ZH. Pediatriya 2015; 2 (3) (in Russian).
  6. Hesham Abdel-Hady, Nehad Nasef, Abd Elazeez Shabaan, Islam Nour. Patent ductus arteriosus in preterm infants: do we have the right answers? Biomed Res Int 2013; 2013: 676192.
  7. Sehgal A, McNamara P.J. International perspective on management of a patent ductus arteriosus: Lessons learned. Semin Fetal Neonatal Med 2018; 23 (4): 278–284.
  8. Chandra Rath Martin Kluckow. Chapter 25 – Pathophysiology Based Management of the Hemodynamically Significant Ductus Arteriosus in the Very Preterm Neonate Hemodynamics and Cardiology (Third Edition) Neonatology Questions and Controversies 2019; 447–467.
  9. Ramakrishnan S., Heung Y.M., Round J. et al. Early N-ter minal probrain natriuretic peptide measurements predict clinically significant ductus arteriosus in preterm infants. Acta Paediatr 2009; 98 (8): 1254–1259.
  10. Ward C.J., Purdie J. Diagnostic accuracy of paediatric echocardiograms interpreted by individuals other than paediatric cardiologists. J Paediatr Child Health 2001; 37 (4): 331–336.
  11. Nick Evans, Veronique Gournay, Fernando Cabanas, Martin Kluckow, Tina Leone, Alan Groves, Patrick McNamara, Luc Mertens Point-of-care ultrasound in the neonatal intensive care unit: international perspectives. Semin Fetal Neonatal Med 2011; 16 (1): 61–68.
  12. Takeishi Y. Biomarkers in heart failure. Int Heart J 2014; 55 (6): 474–481.
  13. Kozlova I.A., Kharlamova I.Y. Natriuretic peptides: biochemistry, physiology, clinical significance. General Reanimatology 2009; V (1): 89–97 (in Russian).
  14. Volodin N.N., Baybarina E.N. Protocol for the management of premature infants with a hemodynamically significant functioning ductus arteriosus. Metodicheskie rekomendatsii. Ed by. Moscow 2010 (in Russian).
  15. Furman E.G., Permyakova A.V., Biyanov A.N., Bahmet'eva O.B., Bithaeva M.V., Porodikov AA. A method for predicting hemodynamically significant functioning ductus arteriosus in premature infants. FGBOU VO Permskij gosudarstvennyj medicinskij universitet im. akademika E.A. Vagnera patent pat. № 2 702 990. 10.15.2019 (in Russian).
  16. Letshwiti J.B., Sirc J., O’Kelly R., Miletin J. Serial N-terminal probrain natriuretic peptide measurement as a predictor of significant patent ductus arteriosus in preterm infants beyond the first week of life. J Pediatr 2014; 173 (11): 1491–1496.
  17. Jeong H.A., Shin J., Kim E., et al. Correlation of B-type natriuretic peptide levels and echocardiographic parameters in preterm infants with patent ductus arteriosus. Korean J Pediatr 2016; 59 (4): 183–189.
  18. Kim J.S., Shim E.J. B-type natriuretic peptide assay for the diagnosis and prognosis of patent ductus arteriosus in preterm infants. Korean Circ J 2012; 42 (3): 192–196.
  19. El-Khuffash A., Amoruso M., Culliton M., Molloy E.J. N-terminal pro-B-type natriuretic peptide as a marker of ductal haemodynamic significance in preterm infants: a prospective observational study. Arch Dis Child Fetal Neonatal 2007; 92 (5): F421–422.

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2. Fig. Concentrations of NT-pro-BNP in the main and comparison groups

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Copyright (c) 2021 Porodikov A.A., Biyanov A.N., Permyakova A.V., Tuktamyshev V.S., Kuchumov A.G., Pospelova N.S., Furman E.G., Onoprienko M.N.

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