BNP, troponin I, and YKL-40 as screening markers in extremely preterm infants at risk for pulmonary hypertension associated with bronchopulmonary dysplasia

作者：Konig Kai^*; Guy Katelyn J; Nold Petry Claudia A; Barfield Charles P; Walsh Geraldine; Drew Sandra M; Veldman Alex; Nold Marcel F; Casalaz Dan M

来源：American Journal of Physiology - Lung Cellular and Molecular Physiology, 2016, 311(6): L1076-L1081.

DOI：10.1152/ajplung.00344.2016

• biomarker
• bronchopulmonary dysplasia
• preterm infants
• pulmonary hypertension
• B-type natriuretic peptide

Bronchopulmonary dysplasia (BPD) is often complicated by pulmonary hypertension (PH). We investigated three biomarkers potentially suitable as screening markers for extremely preterm infants at risk of BPD-associated PH. In this prospective observational cohort study conducted in a tertiary neonatal intensive care unit, 83 preterm infants with BPD born <28-wk gestation and still inpatients at 36-wk corrected age received an echocardiogram and blood tests of B-type natriuretic peptide (BNP), troponin I, and YKL-40. Infants were analyzed according to echocardiographic evidence of tricuspid regurgitation (TR). Thirty infants had evidence of TR on echocardiogram at 36-wk corrected age. Infants with or without TR had similar baseline demographics: mean +/- SD gestational age 26(1) +/- 1(2) vs. 26(1) +/- 11 wk and birth weight 830 +/- 206 vs. 815 +/- 187 g, respectively. There was no difference in duration of respiratory support. The right ventricular systolic pressure of infants with evidence of TR was 40 +/- 16 mmHg. BNP was the only biomarker that proved to be significantly higher in infants with evidence of TR: median (interquartile range) serum level 54.5 (35-105) vs. 41.5 (30-59) pg/ ml, P = 0.043. Subgroup analysis of infants with severe BPD requiring discharge on home oxygen or BPD-related mortality revealed similar results. There was no difference between groups for troponin I and YKL-40. In conclusion, increased serum levels of BNP were associated with evidence of TR at 36-wk corrected gestational age in extremely preterm infants, suggesting a potential role as a screening biomarker for BPD-associated PH.

• 出版日期2016-12-1
• 单位河北医科大学