adrenomedullin and Ductus-Arteriosus--Patent

The evaluation of the patent ductus arteriosus (PDA) in the very premature neonate is a challenge. Echocardiography provides an interpretation of the hemodynamic condition. It is however, only a snapshot. Biomarkers may represent a physiological response to the hemodynamic alterations brought on by the PDA and may add to the identification of the clinical significant PDA.. To investigate the association between mid regional proadrenomodulin (MR-proADM), N-terminal pro b-type natriuretic peptide (NT-proBNP), mid regional pro-atrial natriuretic peptide (MR-proANP), C-terminal pro endothelin-1 (CT-proET1) and copeptin and echocardiographic measures of PDA.. Cohort study with echocardiography performed on day 3 and 6. Blood samples from day 3.. 139 consecutive neonates born at a gestational age <32 weeks.. The main outcomes were presence of a PDA day 3 and 6, PDA diameter, left atrium to aorta ratio (LA:Ao-ratio), and descending aorta diastolic flow (DADF).. Adjusted plasma levels of all investigated biomarkers, except CT-proET1, were found to be associated with both PDA diameter and LA:Ao-ratio, and also the presence of a large PDA. CT-proET1 and copeptin was found to be associated with abnormal DADF. Using pre-specified cut-off values NT-proBNP and MR-proANP day 3 seemed to be of value in identifying a large PDA day 3 and 6 in very preterm neonates.. Among the investigated biomarkers NT-proBNP and MR-proANP performed best in relation to echocardiographic markers of PDA severity in very preterm neonates.

Topics: Adrenomedullin; Atrial Natriuretic Factor; Biomarkers; Ductus Arteriosus, Patent; Echocardiography; Electrocardiography; Endothelin-1; Female; Glycopeptides; Humans; Infant, Newborn; Infant, Premature; Male; Natriuretic Peptide, Brain

To observe the changes of heart rate variability (HRV), adrenomedullin (ADM) and B-type natriuretic peptide (BNP) before and after transcatheter closure in children with patent ductus arteriosus.. HRV spectral values (TF, VLF, LF, HF, LF/HF) were detected by 24 dynamic electrocardiogram and the concentrations of plasma ADM and BNP were measured in 55 children with patent ductus arteriosus (Group PDA, n = 55) before and 3(rd) day, 3(rd) month after transcatheter closure therapy, and in 60 normal children (Group C).. (1) Compared with Group C, the HRV spectral values (TF, VLF, HF) were significantly lower (all P < 0.01), LF/HF and the concentrations of plasma ADM, BNP were significantly higher in patients with PDA before transcatheter closure (all P < 0.01). (2) Compared with the values before transcatheter closure values, plasma ADM were significantly reduced at 3(rd) day and 3(rd) month after transcatheter closure (P < 0.01), the HRV spectral values (TF, VLF, HF) were significantly increased while LF/HF and plasma BNP were significantly decreased at 3(rd) month after transcatheter closure (P < 0.01 or P < 0.05).. HRV and plasma ADM, BNP improved significantly post transcatheter closure in children with patent ductus arteriosus.

Topics: Adolescent; Adrenomedullin; Cardiac Catheterization; Child; Ductus Arteriosus, Patent; Female; Heart Rate; Humans; Male; Natriuretic Peptide, Brain; Young Adult