Published online February 1, 2005
PEDIATRICS Vol. 115 No. 3 March 2005, pp. e255-e261 (doi:10.1542/peds.2004-1837)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Choi, B. M.
Right arrow Articles by Lee, J. W.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Choi, B. M.
Right arrow Articles by Lee, J. W.
Related Collections
Right arrow Heart & Blood Vessels
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

ELECTRONIC ARTICLE

Utility of Rapid B-Type Natriuretic Peptide Assay for Diagnosis of Symptomatic Patent Ductus Arteriosus in Preterm Infants

Byung Min Choi, MD, Kee Hyoung Lee, MD, Baik Lin Eun, MD, Kee Hwan Yoo, MD, Young Sook Hong, MD, Chang Sung Son, MD and Joo Won Lee, MD

From the Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea

Objective. In preterm infants, the rapid and accurate determination of the presence of a hemodynamically significant patent ductus arteriosus (PDA) is extremely important, but this is often difficult. Plasma B-type natriuretic peptide (BNP) measurement has been reported to be a helpful aid in the diagnosis of hemodynamically significant PDA in preterm infants. The aim of our study was to investigate the usefulness of a rapid BNP assay as a diagnostic marker of symptomatic PDA (sPDA) in preterm infants.

Methods. Sixty-six preterm infants, ranging from 25 to 34 gestational weeks of age, underwent clinical and echocardiographic examinations for PDA every other day from the third day of life until the disappearance of ductal flow. Blood samples were collected and plasma BNP concentrations were measured simultaneously using a commercial kit, (Triage BNP test kit; Biosite Diagnositics, San Diego, CA). When ≥2 clinically significant features of PDA were noted, and a large ductal flow was confirmed by color Doppler echocardiography, sPDA was diagnosed and treated with indomethacin.

Results. On the third day after birth, the mean BNP concentration in the sPDA group (n = 23) was significantly higher than in the control group (n = 43) (2896 ± 1627 vs 208 ± 313 pg/mL). Seventeen infants (74%) in the sPDA group became asymptomatic after an initial course of indomethacin and their BNP levels concomitantly decreased. Moreover, BNP concentrations were significantly correlated with the magnitudes of the ductal shunt, such as the ratio of left atrial to aortic root diameter and the diastolic flow velocity of the left pulmonary artery (r = 0.726 and 0.877). The area under the receiver operator characteristic curve for the detection of sPDA was high: 0.997 (95% confidence interval: 0.991–1.004). The best cutoff of BNP concentration for the diagnosis of sPDA was determined to be 1110 pg/mL (sensitivity: 100%; specificity: 95.3%).

Conclusion. In preterm infants, the circulating BNP levels correlated well with the clinical and echocardiographic assessments of PDA. Although not a stand-alone test, the rapid BNP assay provides valuable information for the detection of infants with sPDA that require treatment. Moreover, serial BNP measurements may be of value in determining the clinical course of PDA in preterm infants.

Key Words: patent ductus arteriosus • B-type natriuretic peptide • preterm infants • symptomatic PDA

Abbreviations: PDA, patent ductus arteriosus • hsPDA • hemodynamically significant patent ductus arteriosus • BNP, B-type natriuretic peptide • sPDA, symptomatic patent ductus arteriosus • LA/AO, a ratio of left atrium to the aortic root diameter • DFLPA, diastolic flow velocity of the left pulmonary artery • ROC, receiver operator characteristic • asPDA, asymptomatic patent ductus arteriosus

Accepted Nov 8, 2004.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 Arch. Dis. Child. Fetal Neonatal Ed.Home page
J T Attridge, D A Kaufman, and D S Lim
B-type natriuretic peptide concentrations to guide treatment of patent ductus arteriosus
Arch. Dis. Child. Fetal Neonatal Ed., May 1, 2009; 94(3): F178 - F182.
[Abstract] [Full Text] [PDF]

Home page
 Arch. Dis. Child. Fetal Neonatal Ed.Home page
I Farombi-Oghuvbu, T Matthews, P D Mayne, H Guerin, and J D Corcoran
N-terminal pro-B-type natriuretic peptide: a measure of significant patent ductus arteriosus
Arch. Dis. Child. Fetal Neonatal Ed., July 1, 2008; 93(4): F257 - F260.
[Abstract] [Full Text] [PDF]

Home page
 BMJHome page
Minerva
BMJ, April 9, 2005; 330(7495): 854 - 854.
[Full Text] [PDF]