Exploring the NT-proBNP expression in Premature Infants with Patent Ductus Arteriosus (PDA) by Echocardiography.

Yunlong Shi,Chunying Wang,Jianwei Ji

doi:10.12669/pjms.37.6-wit.4853

Abstract

Objectives:To investigate the correlation between echocardiographic indicators and the expression level of N-terminal pro-brain natriuretic peptide (NT-proBNP) in premature infants (PIs) with patent ductus arteriosus (PDA) and the value of NT-proBNP in diagnosing symptomatic PDA (sPDA) in PIs whose gestational age (GA) was less than 32 weeks.Methods:Ninty premature infants were selected as the research objects, including 52 in the non-PDA group and 38 in the PDA group (26 sPDA cases and 12 cases with asymptomatic PDA (asPDA)) from February 2019 to March 2020. The general information of these infants was recorded, including gender, delivery method, maternal infection, and serum NT-proBNP level on the 3rd day after birth. They were screened by echocardiographic indicators under an artificial intelligence convolutional neural network (AI-CNN). The Receiver Operating Characteristic (ROC) curves were illustrated to decide serum NT-proBNP expression levels, thereby determining specificity and sensitivity of sPDA and the correlation between serum sPDA NT-proBNP expression and echocardiographic indicators.Results:The expression level of serum NT-proBNP in the sPDA group was greater than that in the asPDA group and the non-PDA group (P<0.001). The serum NT-proBNP expression level was positively correlated with the diameter of the ductus arteriosus in the sPDA group (r=0.462, P<0.001); it was also positively correlated with the ratio of left atrium/aorta (LA/AO) (r=0.573, P<0.001), but was not correlated with left ventricular ejection fraction (LVEF) (r=-0.015, P=0.747).Conclusion:The combination of serum NT-proBNP expression and echocardiography had clinical values in early diagnosis of PDA.

Highlights

The birth weights of premature infants (PIs) in the patent ductus arteriosus (PDA) group and the non-PDA group were 1,496±241g and 1,543±262g in turn, and there was no statistical significance between the two groups (P>0.05)
The results of Kulkarni et al.15 showed that NTProBNP is different in the clinical diagnosis of hsPDA in PI, which may be related to the difference in measurement methods and instruments
The expression levels of NT-proBNP were higher in PDA patients than those in non-PDA PIs; in the PDA group, the NT-proBNP levels were higher in symptomatic PDA (sPDA) patients than those in the asymptomatic PDA (asPDA) patients

Summary

Introduction

Plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) can reflect left ventricular load and pulmonary blood volume, and has the physiological functions of diuresis, natriuretic excretion, vasodilation, and reduction of peripheral vascular resistance. It can effectively regulate the changes in peripheral blood of cells and plays a very important role in the prediction of sPDA. The research results of PDA and NT-proBNP are different by many researchers, and there are differences due to various detection methods and observation populations. In this study, artificial intelligence convolutional neural network (AI-CNN) was adopted to optimize the echocardiography and improve imagePak J Med Sci September 2021 (Speical Issue Online) Vol 37 No 6 www.pjms.org.pk 1615 resolution, so as to study and analyze the ratio of left atrium/aorta (LA/AO) correlation, providing reference value for early diagnosis of PDA in clinic.. Plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) can reflect left ventricular load and pulmonary blood volume, and has the physiological functions of diuresis, natriuretic excretion, vasodilation, and reduction of peripheral vascular resistance.. Plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) can reflect left ventricular load and pulmonary blood volume, and has the physiological functions of diuresis, natriuretic excretion, vasodilation, and reduction of peripheral vascular resistance.1-4 It can effectively regulate the changes in peripheral blood of cells and plays a very important role in the prediction of sPDA.. Pak J Med Sci September 2021 (Speical Issue Online) Vol 37 No 6 www.pjms.org.pk 1615 resolution, so as to study and analyze the ratio of left atrium/aorta (LA/AO) correlation, providing reference value for early diagnosis of PDA in clinic.

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