Zafra-Rodríguez Pamela, Méndez-Abad Paula, Lubián-López Simón P, Benavente-Fernández Isabel
Department of Neonatology, "Puerta del Mar" University Hospital, Avda. Ana de Viya, 21, 11009, Cadiz, Spain.
Pediatr Cardiol. 2019 Aug;40(6):1165-1170. doi: 10.1007/s00246-019-02125-z. Epub 2019 Jun 7.
The objective is to examine the correlation between plasma levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) and tissue Doppler imaging (TDI) echocardiographic parameters in the first 28 days of life in very-low-birth-weight infants (VLBWI). VLBWI admitted to the Neonatal Intensive Care Unit (NICU) at Hospital Puerta del Mar, Spain, from January 2015 to January 2017 were prospectively enrolled. Weekly determination of plasma NT-proBNP (pg/mL), and echocardiograms were done during the first 28 days of life. 101 preterm infants with a mean GA of 28.85 weeks (± 1.85 SD) and mean birth weight of 1152 g (± 247.4 SD) were included. A total of 483 echocardiograms and 139 NT-proBNP determinations were performed. We found a negative correlation between plasma NT-proBNP levels and diastolic velocities: mitral A' (ρ = - 0.15, p = 0.04), mitral E' (ρ = - 0.17, p = 0.02), tricuspid A' (ρ = - 0.20, p = 0.006), tricuspid E' (ρ = - 0.24, p = 0.0009). In the first 24 h of life, NT-proBNP levels were strongly correlated with mitral A' and E' velocities in patients with no patent ductus arteriosus (PDA) (ρ = - 0.75, p = 0.04). In preterm patients, elevated NT-proBNP levels are related to worse diastolic myocardial function. In the first 24 h, this correlation is much stronger in the absence of PDA.
目的是研究极低出生体重儿（VLBWI）出生后第1个28天内血浆N末端脑钠肽前体（NT-proBNP）水平与组织多普勒成像（TDI）超声心动图参数之间的相关性。前瞻性纳入2015年1月至2017年1月在西班牙马尔港医院新生儿重症监护病房（NICU）收治的VLBWI。在出生后的第1个28天内，每周测定血浆NT-proBNP（pg/mL）并进行超声心动图检查。纳入了101例平均胎龄为28.85周（±1.85标准差）、平均出生体重为1152 g（±247.4标准差）的早产儿。共进行了483次超声心动图检查和139次NT-proBNP测定。我们发现血浆NT-proBNP水平与舒张期速度之间呈负相关：二尖瓣A'（ρ = -0.15，p = 0.04）、二尖瓣E'（ρ = -0.17，p = 0.02）、三尖瓣A'（ρ = -0.20，p = 0.006）、三尖瓣E'（ρ = -0.24，p = 0.0009）。在出生后的第1个24小时内，无动脉导管未闭（PDA）的患者中，NT-proBNP水平与二尖瓣A'和E'速度密切相关（ρ = -0.75，p = 0.04）。在早产儿中，NT-proBNP水平升高与舒张期心肌功能较差有关。在出生后的第1个24小时内，在无PDA的情况下这种相关性更强。
