Abstract 12485: Amniotic Fluid Level of NTproBNP as a Novel Biomarker of Heart Failure in Neonates and Infants

Abstract

Background and Aim: Recent advances in fetal echocardiography technology and its widespread use have made it possible to evaluate fetal cardiac function and heart failure more accurately, although there is a paucity of clinically useful biomarkers for the diagnosis of heart failure in neonates. N-terminal prohormone of brain natriuretic peptide (NT-proBNP) in blood is one of the established biomarkers for heart failure and is known to be reduced exponentially after birth in children born full-term but not in premature infants. Nearly all (95%) NT-proBNP in the blood is excreted in urine. All amniotic fluid is replaced by fetal urine after the second trimester. The aim of this study was to investigate whether amniotic fluid NT-proBNP could be a potentially useful biomarker to assess severity of heart failure in neonates. Methods: We conducted a retrospective cohort study of 13 neonates, including 1 congenital heart disease patient not affected by chromosomal anomalies. We collected peripheral blood, umbilical vein blood, and amniotic fluid to assess each correlations: 1) between levels of umbilical vein blood NT-proBNP (uvNT/cre) and serum NT-proBNP (sNT/cre); 2) between levels of NT-proBNP in amniotic fluid(aNT/cre) and umbilical vein blood NT-proBNP (uvNT/cre); 3) between levels of NT-proBNP in amniotic fluid(aNT/cre) and serum NT-proBNP (sNT/cre). Results: Average gestational age for the subjects was 36±2.0 weeks and average birth weight were 2321.9±557.3g. 2 patients need treatment for heart failure. Our data revealed that there were very strong correlations between uvNT/cre and sNT/cre (R=0.970, p<0.05) as well as between aNT/cre and uvNT (R=0.712, p<0.05), between aNT/cre and sNT (R=0.685, p<0.05) respectively, in neonates. Conclusion: Our data demonstrated that aNT/cre could be a useful biomarker for diagnosing heart failure in neonates/fetuses after the third trimester.