USING ECHOCARDIOGRAPHY TO INVESTIGATE THE EXPRESSION OF NT-PROBNP IN PREMATURE INFANTS WITH PATENT DUCTUS ARTERIOSUS

Abstract

BACKGROUND: This study aimed to evaluate the relationship between PDA, serum NT-proBNP levels at 2–3 and 8–9 days of life, and BPD/death in very preterm infants. Patent ductus arteriosus (PDA) is a common complication in very preterm infants. It is known that there is an association between PDA and development of bronchopulmonary dysplasia (BPD) or death before the postmenstrual age (PMA) of 36 weeks. However, this association remains one of the most contentious aspects of the problem.

METHODS: Ninety premature infants were chosen as the subjects of the study between February 2019 and March 2020, including 52 in the non-PDA group and 38 in the PDA group (26 sPDA cases and 12 cases with asymptomatic PDA, or asPDA). On the third day following delivery, the general data about these babies was documented, including their gender, delivery technique, maternal infection, and blood NT-proBNP level. Under the guidance of an artificial intelligence convolutional neural network, they were screened using echocardiographic indicators (AI-CNN). The specificity and sensitivity of sPDA as well as the relationship between serum sPDA NT-proBNP expression and echocardiographic markers were ascertained by displaying the Receiver Operating Characteristic (ROC) curves.

RESULTS: The median size of PDA in the first 3 days of life was significantly smaller in infants who survived without BPD. At the same time, echocardiographic signs of hsPDA were significantly more often found in infants who died or developed BPD. There were no statistically significant differences between the groups in the frequency of pharmacological treatment and requirements for the second course of treatment. However, pharmacological treatment of hsPDA did not significantly reduce the incidence of BPD in infants who did not receive treatment, p > 0.05). At the same time, longer persistence of hsPDA did not increase the risk of death or future BPD development (rs = 0.16, p = 0.47).

CONCLUSION: The expression level of serum NT-proBNP on the 3rd day after birth was closely related to the diameter of ductus arteriosus and progress of LA/AO, which had clinical value for early diagnosis of PDA. However, the sample size of included PIs was small, which would lead to some errors or a bias compared to the actual situations. In the future, the sample size would be increased for in-depth research.

KEYWORDS: Echocardiography, NT-proBNP and Symptomatic PDA