N-Terminal-pro-B Type Natriuretic Peptide as a Useful Tool to Evaluate Pulmonary Hypertension and Cardiac Function in CDH Infants

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...

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Veröffentlicht in:Neonatology (Basel, Switzerland) Switzerland), 2008-01, Vol.94 (1), p.22-30
Hauptverfasser: Baptista, Maria J., Rocha, Gustavo, Clemente, Fátima, Azevedo, Luís F., Tibboel, Dick, Leite-Moreira, Adelino F., Guimarães, Hercília, Areias, José C., Correia-Pinto, Jorge
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Sprache:eng
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Zusammenfassung: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.
ISSN:1661-7800
1661-7819
DOI:10.1159/000112641