NTproBNP as a surrogate biomarker for early screening of pulmonary hypertension in preterm infants with bronchopulmonary dysplasia

Dasgupta, Soham; Aly, Ashraf M.; Malloy, Michael H.; Okorodudu, Anthony O.; Jain, Sunil K.

doi:10.1038/s41372-018-0164-1

Cited by 24 publications

(16 citation statements)

References 16 publications

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“…Pro BNP synthesized and secreted by myocardial cells is cleaved into bioactive Btype natriuretic peptide (BNP) and inactive NT-proBNP when volume and pressure are overloaded. Studies have demonstrated that serum NT-proBNP appears to be a good screening tool in BPD-associated pulmonary hypertension (12), and Blanco et.al demonstrated the NT pro-BNP of 5-10 days after birth may identify preterm infants with high risk of BPD (26). In our study, preterm infants in the BPD group displayed significantly higher levels of NT-proBNP in the serum than those in the non-BPD group.…”

Section: Discussionsupporting

confidence: 56%

“…In addition to the predictors above, some biological markers were found to be useful in identifying BPD early. There is evidence showing an association between increased N-terminal-pro brain natriuretic peptide (NT-proBNP) levels and neonatal morbidities such as BPD and pulmonary hypertension (12), but it has not been included in a model establishment currently. Therefore, our aim of the current study was to develop a clinical prediction model, including clinical characteristics and biochemical indexes, to identify very-low-birth-weight infants with high BPD risk.…”

Section: Introductionmentioning

confidence: 99%

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Development and Validation of a Nomogram for Predicting Bronchopulmonary Dysplasia in Very-Low-Birth-Weight Infants

et al. 2021

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Background: Bronchopulmonary dysplasia is a common pulmonary disease in newborns and is one of the main causes of death. The aim of this study was to build a new simple-to-use nomogram to screen high-risk populations.Methods: In this single-center retrospective study performed from January 2017 to December 2020, we reviewed data on very-low-birth-weight infants whose gestational ages were below 32 weeks. LASSO regression was used to select variables for the risk model. Then, we used multivariable logistic regression to build the prediction model incorporating these selected features. Discrimination was assessed by the C-index, and and calibration of the model was assessed by and calibration curve and the Hosmer-Lemeshow test.Results: The LASSO regression identified gestational age, duration of ventilation and serum NT-proBNP in the 1st week as significant predictors of BPD. The nomogram-illustrated model showed good discrimination and calibration. The C-index was 0.853 (95% CI: 0.851–0.854) in the training set and 0.855 (95% CI: 0.77–0.94) in the validation set. The calibration curve and Hosmer-Lemeshow test results showed good calibration between the predictions of the nomogram and the actual observations.Conclusion: We demonstrated a simple-to-use nomogram for predicting BPD in the early stage. It may help clinicians recognize high-risk populations.

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Section: Discussionsupporting

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Development and Validation of a Nomogram for Predicting Bronchopulmonary Dysplasia in Very-Low-Birth-Weight Infants

et al. 2021

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“…At the same time, the response of pulmonary vessels to oxygen may be enhanced, and mild hypoxia can also lead to a significant increase in pulmonary artery pressure (46). Many studies have shown that children with PH have higher levels of NT-proBNP (47)(48)(49)(50). In addition to postnatal factors, experimental studies support epidemiological findings that prenatal causes not only short-term abnormalities in respiratory function, but also persistent destruction of the lung and pulmonary vascular structure throughout infancy (such as IUGR).…”

Section: Discussionmentioning

confidence: 99%

Development of a Nomogram for Moderate-to-Severe Bronchopulmonary Dysplasia or Death: Role of N-Terminal Pro-brain Natriuretic Peptide as a Biomarker

et al. 2021

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Objectives: This study aimed to explore the clinical value of N-terminal pro-brain natriuretic peptide (NT-proBNP) in predicting moderate-to-severe bronchopulmonary dysplasia (BPD)/death, and to establish an effective clinical predictive nomogram.Methods: We retrospectively analyzed very low birth weight infants (VLBWs) with gestational age ≤ 32 weeks. The NT-proBNP values were determined on the 1st, 3rd, 7th, 14th, 21st, and 28th days after birth. The correlation between NT-proBNP level and moderate-to-severe BPD/death was evaluated. Receiver operating characteristic (ROC) curve analysis was used to evaluate the prediction ability. Then, we used multivariable logistic regression to build the prediction model and nomogram, and calibration of the model was assessed by calibration curve.Results: In total, 556 VLBWs were involved, among whom 229 developed BPD (mild: n = 109; moderate: n = 68; severe: n = 52) and 18 died. The NT-proBNP level in the moderate-to-severe BPD/death group was significantly higher than that in the no-to-mild BPD group from the 3rd to 28th day (P < 0.001). When the natural logarithm of the serum NT-ProBNP level increased by 1 unit at day 7 (±2 days) of life, the risk of moderate and severe BPD/death was the highest (OR = 3.753; 95% CI: 2.984~4.720), and ROC analysis identified an optimal cutoff point of 3360 ng/L (sensitivity: 80.0%; specificity: 86.2%; AUC: 0.861). After adjusting for confounding factors, the level of NT-proBNP at day 7 (±2 days) of life still had important predictive value for the development of moderate-to-severe BPD/death, significantly improving the predictive ability of the model.Conclusion: The level of NT-proBNP at day 7 (±2 days) of life can be used as an early promising biomarker for VLBWs to develop moderate-to-severe BPD/death. We constructed an early predictive nomogram to help clinicians identify high-risk populations.

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“…In infants with BPD, NTproBNP is a suggested marker of pulmonary hypertension (3,13). NTproBNP levels in the first month of life increase in VLBWIs who develop BPD (12,14), as we have previously shown (15), and are related to the degree of BPD (16,17).…”

Section: Introductionmentioning

confidence: 79%

Myocardial Function Maturation in Very-Low-Birth-Weight Infants and Development of Bronchopulmonary Dysplasia

et al. 2020

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Background: Myocardial function in very-low-birth-weight infants (VLBWIs) develops during early postnatal life, but different patterns of temporal evolution that might be related to the development of bronchopulmonary dysplasia (BPD) are not completely understood. Methods: A prospective cohort study including VLBWIs admitted to our NICU from January 2015 to 2017 was conducted. Plasma N-terminal pro B type natriuretic peptide (NTproBNP) levels were measured, and echocardiograms were performed at 24 and 72 h of life and weekly thereafter until 36 weeks of postmenstrual age (PMA). We measured the tricuspid annular plane systolic excursion (TAPSE) by M-mode; the lateral tricuspid E', A', and S' waves; and the myocardial performance index (MPI) by tissue doppler imaging (TDI). The subjects were divided into non-BPD and BPD groups. Results: We included 101 VLBWIs. The TAPSE and E', A', and S' waves increased while MPI-TDI decreased over time. Birth gestational age (GA) and postnatal PMA impacted these parameters, which evolved differently in those who developed BPD compared to those in the non-BPD group. The NTproBNP levels at 14 days of life and different echocardiographic parameters were associated with the development of BPD in different multivariate models. Conclusion: TAPSE and TDI values depend on GA and PMA and follow a different temporal evolution that is related to the later development of BPD. Combined biochemical and echocardiographic biomarkers can help identify which VLBWIs are at higher risk of developing BDP.

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NTproBNP as a surrogate biomarker for early screening of pulmonary hypertension in preterm infants with bronchopulmonary dysplasia

Abstract: NTproBNP appears to be a good screening tool to determine the onset of BPD-PH as early as 28 weeks CGA.

Cited by 24 publications

References 16 publications

Development and Validation of a Nomogram for Predicting Bronchopulmonary Dysplasia in Very-Low-Birth-Weight Infants

Development and Validation of a Nomogram for Predicting Bronchopulmonary Dysplasia in Very-Low-Birth-Weight Infants

Development of a Nomogram for Moderate-to-Severe Bronchopulmonary Dysplasia or Death: Role of N-Terminal Pro-brain Natriuretic Peptide as a Biomarker

Myocardial Function Maturation in Very-Low-Birth-Weight Infants and Development of Bronchopulmonary Dysplasia

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