B-type natriuretic peptide is a biomarker for pulmonary hypertension in preterm infants with bronchopulmonary dysplasia

Abstract

Purpose of Study: B-type natriuretic peptide (BNP) is a cardiac biomarker commonly used in adults for screening and follow up of pulmonary hypertension (PH). Currently, there is no evidence that BNP could also be used as a potential marker for PH among infants with bronchopulmonary dysplasia (BPD). This study sought to investigate the relation of serum BNP levels with echocardiographic evidence of PH in infants with BPD. Methods Used: We performed a retrospective chart review from 2010 to 2011 of preterm infants with BPD to identify patients who (1) underwent echocardiography for screening or follow up of PH and (2) had serum BNP levels measured within 3 days of echocardiography. Identified infants were divided into two groups based on presence or absence of PH as determined by echocardiography. Demographics and clinical characteristics were compared, and mean BNP levels correlated with echocardiography results. Summary of Results: Twenty infants (mean gestational age 25.8 T 2 weeks and mean birth weight 825.4 +/- 353 grams) had 30 paired echocardiograms and BNP measurements available. Twenty (67%) had PH based on echocardiography. No significant differences were found in gestational age, birth weight, sex, race, or medications for PH between the two groups. Infants with PH had significantly higher BNP values compared to infants without PH (1032 +/- 1328 pg/ml vs. 44 T 39 pg/ml, p=0.027). A BNP value greater than 125 pg/ml was found to be strongly associated with PH diagnosis. Conclusions: High serum BNP levels appear to correlate with a diagnosis of PH on echocardiography and could be an attractive biomarker that may be useful for screening and follow up of PH in infants with BPD.