atrial-natriuretic-factor and Bronchopulmonary-Dysplasia

Bronchopulmonary dysplasia (BPD) is a major complication in preterm infants <32 weeks. We aimed to assess whether plasma levels of mid-regional pro-atrial natriuretic peptide (MR-proANP) and C-terminal pro-endothelin-1 (CT-proET-1) predict respiratory morbidity.. This was a prospective, two-center, observational cohort study. MR-proANP and CT-proET-1 were measured at day 7 (±2) of life. Associations with duration of supplemental oxygen and the composite outcome of moderate or severe BPD or death (BPD/death) were investigated.. Two hundred and twenty-nine infants <32 weeks were included (median gestational age [GA] 29.6 weeks [interquartile range 29.0-30.7], median birth weight 1150 g [IQR 840-1410]). MR-proANP and CT-proET-1 were associated with the duration of supplemental oxygen in univariable analysis (both p < 0.001) but not after adjusting for co-factors. Infants with BPD/death showed higher plasma levels of MR-proANP (623.50 pmol/L [IQR 458.50-881.38] vs. 308.35 pmol/L [IQR 216.72-538.10]; p < 0.001) and CT-proET-1 (255.40 pmol/L [IQR 202.60-311.15] vs. 198.30 pmol/L [IQR 154.70-297.95]; p = 0.015) compared to infants without BPD/death. Levels of both biomarkers were significantly associated with BPD/death in univariable models but not after adjusting for co-factors.. MR-proANP and CT-proET-1 are associated with the duration of supplemental oxygen and the composite outcome BPD/death, but their prognostic value does not complement that of clinical risk factors.. Plasma levels of MR-proANP and CT-proET-1, measured on day 7 of life (±2 days) are associated in univariable analyses with duration of supplemental oxygen and the combined outcome of BPD or death in VLGA infants. Associations between both biomarkers and respiratory morbidity do not persist in multivariable models, in particular when gestational age is included. MR-proANP and CT-proET-1 have limited additional value to predict respiratory morbidity in VLGA infants compared to clinical parameters.

Topics: Atrial Natriuretic Factor; Biomarkers; Bronchopulmonary Dysplasia; Endothelin-1; Humans; Infant; Infant, Newborn; Infant, Premature; Morbidity; Natriuretic Peptides; Oxygen; Peptide Fragments; Prospective Studies; Vasodilator Agents

To assess the prognostic value of early echocardiographic indices of right ventricular function and vasoactive peptides for prediction of bronchopulmonary dysplasia (BPD) or death in very preterm infants.. Prospective study involving 294 very preterm infants (median [IQR] gestational age 28.4 [26.4-30.4] weeks, birth weight 1065 [800-1380] g), of whom 57 developed BPD (oxygen supplementation at 36 weeks postmenstrual age) and 10 died. Tricuspid annular plane systolic excursion (TAPSE), right ventricular index of myocardial performance (RIMP), plasma concentrations of mid-regional pro-atrial natriuretic peptide (MR-proANP) and C-terminal pro-endothelin-1 (CT-proET1) were measured on day 7 of life.. RIMP was significantly increased (median [IQR] 0.3 [0.23-0.38] vs 0.22 [0.15-0.29]), TAPSE decreased (median [IQR] 5.0 [5.0-6.0] vs 6.0 [5.4-7.0] mm), MR-proANP increased (median [IQR] 784 [540-936] vs 353 [247-625] pmol/L), and CT-proET1 increased (median [IQR] 249 [190-345] vs 199 [158-284] pmol/L) in infants who developed BPD or died, as compared to controls. All variables showed significant but weak correlations with each other (rS -0.182 to 0.359) and predicted BPD/death with similar accuracy (areas under receiver operator characteristic curves 0.62 to 0.77). Multiple regression revealed only RIMP and birth weight as independent predictors of BPD or death.. Vasoactive peptide concentrations and echocardiographic assessment employing standardized measures, notably RIMP, on day 7 of life are useful to identify preterm infants at increased risk for BPD or death.

Topics: Area Under Curve; Atrial Natriuretic Factor; Bronchopulmonary Dysplasia; Echocardiography; Endothelin-1; Female; Gestational Age; Humans; Infant, Newborn; Infant, Premature; Infant, Very Low Birth Weight; Male; Prospective Studies; ROC Curve; Up-Regulation; Ventricular Function, Right

Arginine vasopressin (AVP), atrial natriuretic factor, and water balance were examined in the infants with or without bronchopulmonary dysplasia (BPD) during the first 4 wk of life. Fourteen premature infants, nine in the early stage of BPD secondary to respiratory distress syndrome (BPD infants) and five healty low birth wt infants (LBW infants), were the subjects of this study. The water and sodium balance, renal function, and plasma AVP and atrial natriuretic factor concentrations were determined during the first 4 wk of life. Plasma AVP and atrial natriuretic factor levels of BPD infants at the 4th wk of life were higher than those of LBW infants at the corresponding age. Urine osmolality was higher and free water clearance was lower in BPD infants at the 4th wk of life when compared with each parameter in LBW infants, respectively. Paco2 of BPD infants at the 4th wk of life was more elevated than that of LBW infants. These results suggest that elevated plasma AVP level may be related with pulmonary abnormalities and that atrial natriuretic factor may hence compensate the water retention resulted from the functionally activated AVP in the early stage of BPD.

Topics: Arginine Vasopressin; Atrial Natriuretic Factor; Bronchopulmonary Dysplasia; Female; Homeostasis; Humans; Infant, Low Birth Weight; Infant, Newborn; Male; Water

Topics: Adolescent; Atrial Natriuretic Factor; Bronchopulmonary Dysplasia; Child; Child, Preschool; Female; Heart Defects, Congenital; Humans; Infant; Infant, Newborn; Male