Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jul 3;9(7):1002.
doi: 10.3390/children9071002.

Can NT-proBNP Levels Be an Early Biomarker of Reduced Left Ventricular Ejection Fraction in Preterm Infants?

Ya-Lan Lin  1 , Yi-Li Hung  1   2   3 , Chung-Min Shen  1   2 , Yung-Chuan Chen  1 , Wu-Shiun Hsieh  1   4   5
Affiliations

Can NT-proBNP Levels Be an Early Biomarker of Reduced Left Ventricular Ejection Fraction in Preterm Infants?

Ya-Lan Lin et al. Children (Basel). .

Abstract

Background/Objective: N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a cardiac natriuretic hormone that cardiomyocytes release in response to ventricular stretch. It helps with the diagnosis of heart failure in adults, but this application in preterm infants has rarely been reported. This study aimed to evaluate whether NT-proBNP could be used for the early detection of reduced cardiac ejection fraction in preterm infants and the optimal timing for NT-proBNP assessment. Design/Methods: This prospective, single-center, observational study enrolled all preterm infants with NT-proBNP measurements from October 2014 to February 2022. They underwent echocardiographic examinations within 48 h of the NT-proBNP measurements. Reduced left ventricular ejection fraction was defined as below 60%. Receiver operator characteristic (ROC) curves were generated to assess the optimal NT-proBNP cutoff point for the early prediction of reduced cardiac ejection fraction. Results: A total of 68 preterm infants were enrolled, with a total of 134 NT-proBNP measurements being available for analysis. Reduced left ventricular ejection fraction was present in seven infants (10.3%) due to various underlying diseases. The NT-proBNP cutoff level for detecting reduced left ventricular ejection fraction was 9248 pg/mL, with 71.4% sensitivity and 60.8% specificity; the area under the curve was 0.623 (95% CI: 0.487~0.760). The threshold for the optimal postnatal age for applying NT-proBNP to detect reduced left ventricular ejection fraction was >2 days of life (AUC: 0.682; 95% CI: 0.518~0.845), with 70% sensitivity and 67.1% specificity. Conclusions: Although the NT-proBNP levels declined dramatically after birth, a NT-proBNP serum level of 9248 pg/mL might be helpful for the early detection of reduced ejection fraction in preterm infants, and the optimal age for detection was after 2 days of life.

Keywords: N-terminal pro-B-type natriuretic peptide; biomarker; brain natriuretic peptide; ejection fraction; preterm infants.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
NT-proBNP levels before and after treatment with ibuprofen for patients with hemodynamically significant patent ductus arteriosus.
Figure 2
Figure 2
Correlation between N-terminal pro-B-type natriuretic peptide (NT-proBNP) level and age.
Figure 3
Figure 3
Receiver operator characteristic (ROC) curve for N-terminal pro-B-type natriuretic peptide detecting reduced left ventricular ejection fraction at >2 days. The blue line is the receiver operating characteristic curve. The red line is the diagonal reference line.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Cantinotti M., Law Y., Vittorini S., Crocetti M., Marco M., Murzi B., Clerico A. The potential and limitations of plasma BNP measurement in the diagnosis, prognosis, and management of children with heart failure due to congenital cardiac disease: An update. Heart Fail. Rev. 2014;19:727–742. doi: 10.1007/s10741-014-9422-2. - DOI - PubMed
    1. El-Khuffash A., Molloy E. The Use of N-Terminal-Pro-BNP in Preterm Infants. Int. J. Pediatr. 2009;2009:175216. doi: 10.1155/2009/175216. - DOI - PMC - PubMed
    1. Lin C.-W., Zeng X.-L., Zhang J.-F., Meng X.-H. Determining the Optimal Cutoff Values of Plasma N-Terminal Pro–B-Type Natriuretic Peptide Levels for the Diagnosis of Heart Failure in Children of Age up to 14 Years. J. Card. Fail. 2014;20:168–173. doi: 10.1016/j.cardfail.2013.12.013. - DOI - PubMed
    1. Nir A., Lindinger A., Rauh M., Bar-Oz B., Laer S., Schwachtgen L., Koch A., Falkenberg J., Mir T.S. NT-Pro-B-type Natriuretic Peptide in Infants and Children: Reference Values Based on Combined Data from Four Studies. Pediatr. Cardiol. 2008;30:3–8. doi: 10.1007/s00246-008-9258-4. - DOI - PubMed
    1. Gleason C., Juul S. Avery’s Disease of the Newborn. 10th ed. Elsevier Inc.; Amsterdam, The Netherlands: 2018. pp. 780–781. Chapter 53.