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TitleN-terminal-pro-B type natriuretic peptide as a useful tool to evaluate pulmonary hypertension and cardiac function in CDH infants
Author(s)Baptista, Maria João Ribeiro Leite
Rocha, Gustavo
Clemente, Fátima
Azevedo, Luís F.
Tibboel, Dick
Leite-Moreira, Adelino F.
Guimarães, Hercília
Areias, José C.
Correia-Pinto, Jorge
KeywordsBlood Pressure
Case-Control Studies
Hernia, Diaphragmatic
Hypertension, Pulmonary
Infant, Newborn
Natriuretic Peptide, Brain
Peptide Fragments
Prospective Studies
Severity of Illness Index
Hernias, Diaphragmatic, Congenital
N-terminal-pro-B type natriuretic peptide
Cardiac function
congenital diaphragmatic hernia
pulmonary hypertension
Issue date2008
PublisherKarger Publishers
Abstract(s)Objective: In congenital diaphragmatic hernia (CDH) the severity of pulmonary hypertension (PH) is considered, by several authors, determinant of clinical outcome. Plasmatic N-terminal-pro-B type natriuretic peptide (NT-proBNP) might be useful in diagnosis and management of PH in newborns, although its interest in CDH infants remains to be defined. Early NT-proBNP levels were assessed in CDH infants and correlated with cardiovascular echocardiographic parameters. Patients and Methods: 28 newborns, CDH and age-matched controls were enrolled in a prospective study. Clinical condition, NT-proBNP plasmatic levels, echo parameters of PH and biventricular function were assessed at 24 h after delivery as well as survival outcome. Results: Estimated mean pulmonary pressure and NT-proBNP were significantly higher in CDH than control infants. NT-proBNP significantly correlated with estimated pulmonary artery pressure, right ventricular Tei index, and tricuspid E/A ratio. Additionally, we found that CDH infants with NT-proBNP >11,500 pg/ml experienced a worse prognosis. Conclusions: We demonstrated that PH is associated with NT-proBNP elevation and diastolic impairment in CDH infants. Early elevations in NT-proBNP levels seem to alert for a subset of CDH infants with worse prognosis.
AccessRestricted access (Author)
Appears in Collections:ICVS - Artigos em revistas internacionais / Papers in international journals

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