Biochemical Screening for Pulmonary Hypertension in Preterm Infants with Bronchopulmonary Dysplasia
Montgomery, Angela M ; Bazzy-Asaad, Alia ; Asnes, Jeremy D ; Bizzarro, Matthew J ; Ehrenkranz, Richard A and Weismann, Constance G LU
(2016)
In Neonatology
109(3).
p.4-190
- Abstract
BACKGROUND: Pulmonary hypertension (PH) in infants with bronchopulmonary dysplasia (BPD) is associated with increased morbidity and mortality. Elevated levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and decreased levels of amino acid precursors of nitric oxide (NO) have been associated with PH, but have not been studied in infants with PH secondary to BPD.
OBJECTIVE: The aim of this study was to identify a biochemical marker for PH in infants with BPD.
METHODS: Twenty infants, born at <27 weeks' gestational age (GA) and/or with a birth weight (BW) ≤750 g, who met the criteria for BPD at 36 weeks' corrected GA (CGA) were enrolled in this cross-sectional pilot study. A screening echocardiogram was conducted... (More)
BACKGROUND: Pulmonary hypertension (PH) in infants with bronchopulmonary dysplasia (BPD) is associated with increased morbidity and mortality. Elevated levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and decreased levels of amino acid precursors of nitric oxide (NO) have been associated with PH, but have not been studied in infants with PH secondary to BPD.
OBJECTIVE: The aim of this study was to identify a biochemical marker for PH in infants with BPD.
METHODS: Twenty infants, born at <27 weeks' gestational age (GA) and/or with a birth weight (BW) ≤750 g, who met the criteria for BPD at 36 weeks' corrected GA (CGA) were enrolled in this cross-sectional pilot study. A screening echocardiogram was conducted at 36-38 weeks' CGA and plasma NT-proBNP and amino acid levels were obtained within 1 week of the screening echocardiogram.
RESULTS: Five infants (25%) had echocardiographic evidence of PH. GA and BW were not significantly different between the 2 groups (a PH group and a No PH group). NT-proBNP was significantly elevated in the PH group (median 1,650 vs. 520 pg/ml; p = 0.001) but citrulline levels were significantly lower (median 21 vs. 36 μmol/l; p = 0.005). Arginine levels were not significantly different between the groups (median 78 vs. 79 μmol/l; p = 1).
CONCLUSION: NT-proBNP and the NO precursor citrulline may be cost-effective biochemical markers for screening for the presence of PH in preterm infants who have BPD. If validated in a larger study, such biochemical markers may, in part, replace PH screening echocardiograms in these patients.
(Less)
- author
- Montgomery, Angela M
; Bazzy-Asaad, Alia
; Asnes, Jeremy D
; Bizzarro, Matthew J
; Ehrenkranz, Richard A
and Weismann, Constance G
LU
- publishing date
- 2016
- type
- Contribution to journal
- publication status
- published
- keywords
- Biomarkers/blood, Bronchopulmonary Dysplasia/blood, Cross-Sectional Studies, Echocardiography, Female, Humans, Hypertension, Pulmonary/blood, Infant, Newborn, Infant, Premature/blood, Infant, Premature, Diseases/blood, Male, Neonatal Screening/methods, Pilot Projects
- in
- Neonatology
- volume
- 109
- issue
- 3
- pages
- 4 - 190
- publisher
- Karger
- external identifiers
-
- pmid:26780635
- scopus:84955585990
- ISSN
- 1661-7800
- DOI
- 10.1159/000442043
- language
- English
- LU publication?
- no
- id
- 9a8a9e06-8d46-4666-9a7e-676b76cf02a0
- date added to LUP
- 2019-01-25 14:41:06
- date last changed
- 2024-09-18 11:42:01
@article{9a8a9e06-8d46-4666-9a7e-676b76cf02a0,
abstract = {{<p>BACKGROUND: Pulmonary hypertension (PH) in infants with bronchopulmonary dysplasia (BPD) is associated with increased morbidity and mortality. Elevated levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and decreased levels of amino acid precursors of nitric oxide (NO) have been associated with PH, but have not been studied in infants with PH secondary to BPD.</p><p>OBJECTIVE: The aim of this study was to identify a biochemical marker for PH in infants with BPD.</p><p>METHODS: Twenty infants, born at <27 weeks' gestational age (GA) and/or with a birth weight (BW) ≤750 g, who met the criteria for BPD at 36 weeks' corrected GA (CGA) were enrolled in this cross-sectional pilot study. A screening echocardiogram was conducted at 36-38 weeks' CGA and plasma NT-proBNP and amino acid levels were obtained within 1 week of the screening echocardiogram.</p><p>RESULTS: Five infants (25%) had echocardiographic evidence of PH. GA and BW were not significantly different between the 2 groups (a PH group and a No PH group). NT-proBNP was significantly elevated in the PH group (median 1,650 vs. 520 pg/ml; p = 0.001) but citrulline levels were significantly lower (median 21 vs. 36 μmol/l; p = 0.005). Arginine levels were not significantly different between the groups (median 78 vs. 79 μmol/l; p = 1).</p><p>CONCLUSION: NT-proBNP and the NO precursor citrulline may be cost-effective biochemical markers for screening for the presence of PH in preterm infants who have BPD. If validated in a larger study, such biochemical markers may, in part, replace PH screening echocardiograms in these patients.</p>}},
author = {{Montgomery, Angela M and Bazzy-Asaad, Alia and Asnes, Jeremy D and Bizzarro, Matthew J and Ehrenkranz, Richard A and Weismann, Constance G}},
issn = {{1661-7800}},
keywords = {{Biomarkers/blood; Bronchopulmonary Dysplasia/blood; Cross-Sectional Studies; Echocardiography; Female; Humans; Hypertension, Pulmonary/blood; Infant, Newborn; Infant, Premature/blood; Infant, Premature, Diseases/blood; Male; Neonatal Screening/methods; Pilot Projects}},
language = {{eng}},
number = {{3}},
pages = {{4--190}},
publisher = {{Karger}},
series = {{Neonatology}},
title = {{Biochemical Screening for Pulmonary Hypertension in Preterm Infants with Bronchopulmonary Dysplasia}},
url = {{http://dx.doi.org/10.1159/000442043}},
doi = {{10.1159/000442043}},
volume = {{109}},
year = {{2016}},
}