NT-proBNP as an Early Marker of Diastolic Ventricular Dysfunction in Very-Low-Birth-Weight Infants
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.
KeywordsBiomarkers NT-proBNP Patent ductus arteriosus Preterm infants Tissue Doppler
B-type natriuretic peptide
Myocardial performance index
Neonatal Intensive Care Unit
N-terminal pro-brain natriuretic peptide
Patent ductus arteriosus
Tissue Doppler imaging
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.
The study was supported by University Hospital Puerta del Mar from Servicio Andaluz de Salud (Junta de Andalucía, Spain).
Compliance with Ethical Standards
Conflict of interest
The authors declare no conflict of interest.
- 14.Lopez L, Colan SDD, Frommelt PCC, Ensing GJJ, Kendall K, Younoszai AKK et al (2010) Recommendations for quantification methods during the performance of a pediatric echocardiogram: a report from the Pediatric Measurements Writing Group of the American Society of Echocardiography Pediatric and Congenital Heart Disease Council. J Am Soc Echocardiogr 23(5):465–467PubMedCrossRefGoogle Scholar
- 19.Nestaas E, Schubert U, de Boode WP, El-Khuffash A, European Special Interest Group (2018) «Neonatologist Performed Echocardiography» (NPE) Tissue Doppler velocity imaging and event timings in neonates: a guide to image acquisition, measurement, interpretation, and reference values. Pediatr Res 84(Suppl 1):18–29PubMedPubMedCentralCrossRefGoogle Scholar
- 28.Occhipinti F, De Carolis MP, De Rosa G, Bersani I, Lacerenza S, Cota F et al (2014) Correlation analysis between echocardiographic flow pattern and N-terminal-pro-brain natriuretic peptide for early targeted treatment of patent ductus arteriosus. J Matern Fetal Neonatal Med 27(17):1800–1804PubMedCrossRefGoogle Scholar