Changes of three cardiac markers at pre- and post-treatment in preterm infants with patent ductus arteriosus

Abstract

Objective To investigate the changes of cardiac function at pre- and post-treatment in preterm infants with patent ductus arteriosus (PDA) in order to guide drug treatment. Methods Totally 84 preterm infants with PDA admitted to Neonatal Intensive Care Unit of Xuzhou Hospital Affiliated to Medical College of Southeast University from July 2012 to June 2014 were divided into 4 groups according to treatment drug: Ibuprofen group (27 cases), Indomethacin group (24 cases), control group (11 cases), and Paracetamol group (22 cases). Patients were also divided into symptomatic PDA group (38 cases) and asymptomatic PDA group (46 cases) according to severity; PDA closed group (69 cases) and PDA unclosed group (15 cases) according to sequel.The level of plasma brain natriuretic peptide (BNP), cardiac troponin I (cTnI), correct QT intervals dispersion (QTcd) were monitored pre- and post-treatment.Data were analyzed by using SPSS 19.0 software. Results Three cardiac markers at post-treatment were of no significant difference among 4 treatment drugs.The changes of the cTnI and QTcd at pre- and post-treatment were of no significance.The level of BNP in symptomatic PDA group was significantly higher than that in asymptomatic PDA group at pre-treatment [(378±94) ng/L vs (147±75) ng/L, t=2.584, P=0.014]. In the symptomatic PDA group, the level of BNP at post-treatment [(182±81) ng/L] was significantly decreased than that at per-treatment (t=2.741, P=0.009). In the asymptomatic PDA group, there was no significant difference between the pre- and post-treatment [(121±61) ng/L] in the level of BNP (t=1.254, P=0.207). There was no significant difference in the level of BNP at per-treatment between PDA closed group and PDA unclosed group [(274±91) ng/L vs (289±87) ng/L, t=-0.874, P=0.391]. In PDA closed group, the level of BNP at post-treatment [(121±74) ng/L] was significantly decreased compared with that at per-treatment (t=3.580, P=0.000). In PDA unclosed group, there was no significant difference between the pre- and post-treatment [(245±74) ng/L] in the level of BNP (t=0.854, P=0.392). Conclusion Early medication intervention for symptomatic PDA of preterm infants is beneficial for the closure of PDA and for attenuating negative effects on cardiac function of PDA. Key words: Patent ductus arteriosus; Natriuretic peptide, brain; Troponin I; Electrocardiography; Infant, premature