J Korean Pediatr Soc.
2000 Jul;43(7):897-904.
Usefulness of Pasma Atrial Natriuretic Peptide Concentration in the Diagnosis of Patent Ductus Arteriosus in Preterm Infants
- Affiliations
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- 1Department of Pediatrics, College of Medicine, Kwandong University.
- 2Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea.
Abstract
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PURPOSE: Diagnosis of a hemodynamically significant patent ductus arteriosus(PDA) that should
be treated is difficult to determine by clinical and echocardiographic examinations. The aim
of this study was to clarify the interrelationship of plasma atrial natriuretic peptide(ANP)
concentrations and clinical signs or echocardiographic signs of PDA in preterm infants and
use plasma ANP concentrations as a diagnostic indicator of a hemodynamically significant PDA.
METHODS
Twenty-four preterm infants who were born at Guro Hospital, Korea Medical Center were evaluated on the 3rd day after birth. Clinical signs(cardiovascular dysfunction score 3) and echocardiographic signs[magnitude of left-to-right shunt across a PDA and left atrium(LA): Ao ratio] of a PDA and plasma ANP concentrations were measured.
RESULTS
Plasma ANP concentrations and LA/Ao ratios of preterm infants with hemodynamically significant PDA were significantly higher than those of preterm infants without hemodynamically significant PDA. Plasma ANP concentrations were related to the magnitude of the left- to-right shunt across a PDA and LA: Ao ratio. Plasma ANP concentrations of LA/Ao of more than 1.3 were significantly higher than that of LA/Ao of less than 1.3.
CONCLUSION
In preterm infants, high plasma ANP concentration may be a useful predictive indicator of a hemodynarnically significant PDA. Measurement of plasma ANP concentration may play a role in deciding the need for and timing of medical or surgical management of preterm infants with PDA.
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