Troponin T, N-terminal pro natriuretic peptide and a patent ductus arteriosus scoring system predict death before discharge or neurodevelopmental outcome at 2 years in preterm infants

Abstract

Blood cTnT, NTpBNP and a PDA scoring system at 48 h may facilitate the identification of those infants with a PDA, who are at greatest risk of poor neurodevelopmental outcome at 2 years of age.

Cardiovascular dysfunction in infants with neonatal encephalopathy: Table 1

“…NTpBNP and troponin predict poor neonatal outcome (grade III/IV intraventricular haemorrhage or death) in preterm infants with a patent ductus arteriosus (PDA) 40. Troponin, NTpBNP and a PDA scoring system at 48 h may facilitate the identification of those infants with a PDA, who are at greatest risk of poor neurodevelopmental outcome at 2 years of age 40.…”

“…Troponin, NTpBNP and a PDA scoring system at 48 h may facilitate the identification of those infants with a PDA, who are at greatest risk of poor neurodevelopmental outcome at 2 years of age 40. The use of serial echocardiography to determine cardiovascular dysfunction in infants with hypoxic injury may help to predict neurodevelopmental outcome; however, at present, there is a paucity of literature in this field and warrants further research.…”

Plasma C-Terminal Pro-Endothelin-1 and the Natriuretic Pro-Peptides NT-proBNP and MR-proANP in Very Preterm Infants with Patent Ductus Arteriosus

“…Two-dimensional, M-mode, pulse and color flow Doppler imaging were performed. The indication for ductus intervention was based on the presence of the following previously established criteria [20] : presence of PDA with left-to-right shunting, narrowest ductal diameter 6 1.5 mm and LA/Ao ratio 6 1.5, and diastolic retrograde flow in the postductal descending aorta. Treatment of PDA using indomethacin (0.6 mg/kg in 3 or 6 doses at intervals of 12 or 24 h, respectively, depending on clinical considerations) commenced when indicated immediately after echocardiographic measurement.…”

The Decline and Fall of the Cardiac Biomarker: A Good Indicator of Resolution of Cardiac Dysfunction following Perinatal Asphyxia

“…The changes in myocyte membrane permeability resulting from the injury could be enough for the release of cardiac troponins from the free cytosolic pool of myocytes without permanent structural damage. Both BNP and troponin are elevated in preterm infants with a significant patent ductus arteriosus and decrease with closure of the ductus [10,11] and both have been used to evaluate the response to treatment of congenital heart disease [12]. BNP is elevated in persistent pulmonary hypertension of the newborn and correlates well with the pressure gradient across the tricuspid valve [13] and therefore may be a useful marker in infants with persistent pulmonary hypertension of the newborn following perinatal asphyxia.…”

“…Point of care sampling of BNP and troponin would simplify their use in the neonatal intensive care unit as cardiac biomarkers and has been validated for this purpose [15]. Elevated troponin, NTpBNP (inactive by-product of the cleavage of ProBNP to BNP) at 48 h identifies preterm infants with a patent ductus arteriosus at greatest risk of death or poor 2-year neurodevelopmental outcome [11]. Therefore, although initial troponin levels normalize in many infants, the maximum troponin level may indicate the degree of perinatal asphyxia.…”