All issues > Volume 43(7); 2000

Original Article

J Korean Pediatr Soc. 2000;43(7):897-904. Published online July 15, 2000.

Usefulness of Plasma Atrial Natriuretic Peptide Concentration in the Diagnosis of Patent Ductus Arteriosus in Preterm Infants

Byung Min BM Choi¹, Jae Kyun JK Yoon¹, Hyun Hee HH Lee¹, Hae Won HW Cheon², Kee Hwan KH Yoo², Young Sook YS Hong², Joo Won JW Lee², Soon Kyum SK Kim²

¹Department of P ediatrics, College of M edicine, Kwandong University, Seoul, Korea
²Department of Pediatrics, College of M edicine, Korea University, Seoul, Korea

Correspondence Byung Min BM Choi ,Email: CBMin@hitel.net

Abstract

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 hemodynamically 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.

Keywords :Plasma atrial natriuretic peptide, Clinical sign, Echocardiographic sign, Patent ductus arteriosus, Preterm infant