Changes of Plasma Brain Natriuretic Peptide According to the Changes of Ductal Shunt in Healthy Preterm Infants.
- Author:
Jee Yeon LEE
1
;
Won Hee SEO
;
Byung Min CHOI
;
Kee Hyoung LEE
;
Baik Lin EUN
;
Kee Hwan YOO
;
Young Sook HONG
;
Chang Sung SON
;
Joo Won LEE
;
Young Chang TOCKGO
Author Information
1. Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Plasma brain natriuretic peptide;
Hemodynamic change;
Ductal shunt;
Patent ductus arteriosus;
Preterm infant
- MeSH:
Brain*;
Ductus Arteriosus, Patent;
Echocardiography;
Hemodynamics;
Humans;
Infant;
Infant, Newborn;
Infant, Premature*;
Natriuretic Peptide, Brain*;
Parturition;
Plasma*;
Pulmonary Artery
- From:Journal of the Korean Pediatric Cardiology Society
2003;7(1):128-137
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The purpose of this study is to clarify the effect of hemodynamic changes of ductal shunt on brain natriuretic peptide(BNP) secretion and to investigate the value of plasma BNP level as a predictor of spontaneous closure of ductus arteriosus(DA) in healthy preterm infants. METHODS: 24 preterm infants were enrolled. Echocardiographic examinations and blood samplings of BNP were carried out in 24 hours, 72 hours and on 5th days after birth. The magnitudes of ductal shunts were estimated using ductal color Doppler flow pattern, left atrial/aortic root ratio(LA/Ao ratio) and antegrade peak diastolic flow velocity(APDFV) in left pulmonary artery. RESULTS: DA in healthy preterm infants were closed spontaneously within 5 days of birth. Plasma BNP levels in infants with ductal shunt were higher than that of infants without shunt in 24 hours and then significantly decreased within 72 hours of birth according to the decreases of flow in ductal shunts. BNP levels of all infants with ductal shunt were significantly correlated with LA/Ao ratio and APDFV. CONCLUSION: Reduction of BNP levels may serve as an indicator of spontaneous closure of DA in healthy preterm infants. Its levels show significant correlations with the magnitudes of ductal shunt. Therefore BNP levels may be used in determining the necessity of and the optimal time to initiating medical and surgical management of preterm infants with significant PDA.