N-terminal-pro-B type natriuretic peptide as a useful tool to evaluate pulmonary hypertension and cardiac function in CDH infants.

Abstract

OBJECTIVE:

In congenital diaphragmatic hernia (CDH) the severity of pulmonary hypertension (PH) is considered, by several authors, determinant of clinical outcome. Plasmatic N-terminal-pro-B type natriuretic peptide (NT-proBNP) might be useful in diagnosis and management of PH in newborns, although its interest in CDH infants remains to be defined. Early NT-proBNP levels were assessed in CDH infants and correlated with cardiovascular echocardiographic parameters.

PATIENTS AND METHODS:

28 newborns, CDH and age-matched controls were enrolled in a prospective study. Clinical condition, NT-proBNP plasmatic levels, echo parameters of PH and biventricular function were assessed at 24 h after delivery as well as survival outcome.

RESULTS:

Estimated mean pulmonary pressure and NT-proBNP were significantly higher in CDH than control infants. NT-proBNP significantly correlated with estimated pulmonary artery pressure, right ventricular Tei index, and tricuspid E/A ratio. Additionally, we found that CDH infants with NT-proBNP >11,500 pg/ml experienced a worse prognosis.

CONCLUSIONS:

We demonstrated that PH is associated with NT-proBNP elevation and diastolic impairment in CDH infants. Early elevations in NT-proBNP levels seem to alert for a subset of CDH infants with worse prognosis.

• Authors: Maria J Baptista, Gustavo Rocha, Fátima Clemente, Luís F Azevedo, Dick Tibboel, Adelino F Leite-Moreira, Hercília Guimarães, José C Areias, Jorge Correia-Pinto
• Journal: Neonatology (Neonatology) Vol. 94 Issue 1 Pg. 22-30 ( 2008) ISSN: 1661-7819 [Electronic] Switzerland
• PMID: 18160811 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: (c) 2007 S. Karger AG, Basel.

Chemical References

• Peptide Fragments
• pro-brain natriuretic peptide (1-76)
• Natriuretic Peptide, Brain

Topics

• Blood Pressure (physiology)
• Case-Control Studies
• Echocardiography
• Female
• Heart (physiopathology)
• Hernia, Diaphragmatic (blood, physiopathology)
• Hernias, Diaphragmatic, Congenital
• Humans
• Hypertension, Pulmonary (blood, diagnosis, physiopathology)
• Infant, Newborn
• Male
• Natriuretic Peptide, Brain (blood)
• Peptide Fragments (blood)
• Prognosis
• Prospective Studies
• Severity of Illness Index