Srirupa Hari Gopal, Kelly Frances Martinek, Candice Vacher, Judith Becker, Nighy P. Varghese, Betul Yilmaz Furtun, Joseph L. Hagan, Sharada H. Gowda, Mohan Pammi, Sridevi Devaraj, Caraciolo J. Fernandes
Baylor College of Medicine.
United States
Pediatric Research
Pediatr Res 2024;
DOI: 10.1038/s41390-024-03600-x
Abstract
Background: Echocardiography is the reference standard for diagnosing pulmonary hypertension (PH) and cardiac dysfunction (CD) in congenital diaphragmatic hernia (CDH). The use of an adjunct non-invasive biomarker would be invaluable. Plasma N-terminal brain Natriuretic Peptide (NT-proBNP) has been evaluated as a biomarker in CDH. Our objective was to investigate the utility of urinary NT-proBNP as an adjunct biomarker in CDH.
Methods: Prospective observational study of neonates with CDH. Urinary NT-proBNP and its ratio to urinary creatinine (UNBCR) were analyzed at 24 h of life (HOL). Spearman’s correlation was used to quantify the association between the urinary NT-proBNP with corresponding plasma concentrations. Logistic regression and receiver operating characteristic (ROC) curve analyses were used to examine urinary NT-proBNP and UNBCR’s association with need for ECMO. The Kruskal-Wallis test was used to compare urinary NT-proBNP concentrations with echocardiography parameters of PH and CD.
Results: Urinary NT-proBNP and UNBCR positively correlated with plasma concentrations. Patients with high right ventricular (RV) pressures had higher urinary NT-proBNP concentrations. Both urinary NT-proBNP and UNBCR concentrations increased with worsening left and right ventricular dysfunction on first postnatal echocardiogram.
Conclusion: We report the feasibility of urinary NT-proBNP as a non-invasive biomarker to assess PH and CD in CDH.
Category
Class III. Pulmonary Hypertension Associated with Lung Hypoplasia
Right Heart Dysfunction Associated with Pulmonary Vascular Disease
Potential Biomarkers Associated with Pulmonary Vascular Disease
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
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