Статья

Experience of the natriuretic peptide use in the complex diagnosis and treatment of newborns with heart failure

I. Maslennikova, E. Bockeriya, T. Ivanetc, I. Kazantseva, D. Degtyarev,
2020

Objective of the research: to evaluate the diagnostic and prognostic significance of determining NT-proBNP in blood plasma in newborns with congenital heart defects (CHD). Materials and methods: in the Department of Pathology of Newborns and Premature Infants, Department of Newborns, National Medical Research Center for Obstetrics, Gynecology and Perinatology named after V.I. Kulakov, the study of NT-proBNP level in the blood serum of full-term newborns was performed. The study included 133 children who were divided into 3 groups: group 1 (control group, n=41): healthy full-term children without any pathology in the neonatal period. In children of this group, NT-proBNP concentration was determined on the 1st and 7th day of life (d.o.l.), the results were used as NT-proBNP reference values. Group 2: newborns with non-critical CHD without signs of heart failure (HF) (n=24). NT-proBNP was determined in this group at 4–7th d.o.l. (upon admission to the Department of Pathology of Newborns and Premature Infants. Group 3 included newborn children with CHD and HF syndrome of degree 1 or 2A (n=68). NT-proBNP concentration was assessed upon admission at 1–3th d.o.l. (n=24), 4–7th d.o.l. (n=31) and 8–14th d.o.l. (n=17). In 27 children of group 3, the peptide concentration was monitored during ongoing therapy. 9 newborns who needed surgical correction of the defect from group 3 were assigned to subgroup 3A. Blood plasma analysis was performed by electrochemiluminescence on a cobas e411 immunochemical analyzer (Hitachi, Japan). Results: in group 1, on the first day of life, the highest NT-proBNP concentrations were observed (med = 4971 pg/ml, 10‰ – 260 pg/ml, 90‰ – 13 224 pg/ml), which decreased during the first week of life in almost 2,5 times (med = 2087 pg/ml, 10‰ – 331 pg/ml, 90‰ – 4478 pg/ml). In group 2 at the 4–7th d.o.l. the mean value of NT-proBNP was 3306 pg/ml (10‰ – 1506 pg/ml, 90‰ – 5765 pg/ml), which is slightly higher than in children of the reference group. In group 3, the highest concentrations of NT-proBNP were noted: in children with early developed circulatory failure: in 1–3th d.o.l. NT-proBNP amounted to 17 214 pg/ml (10‰ – 4258 pg/ml, 90‰ – 30 363 pg/ml), in 4–7th d.o.l. the mean value was 5077 pg/ml (10‰ – 1535 pg/ml, 90‰ – 25 542 pg/ml). These values exceed the reference more than 3 times. In group 3A, there was a significant increase in the concentration of NT-proBNP compared with other children of group 3, as well as an excess of the control group indicators by more than 5 times (med = 24 093 pg/ml, 10‰ – 4235 pg/ml, 90‰ – 41 115 pg/ml). The analysis of dynamics in children receiving HF therapy revealed a decrease in the concentration of NT-proBNP in the case of compensation. When the condition worsened, an increase in the concentration of NT-proBNP was noted, respectively. Conclusion: in newborns, NT-proBNP concentration at birth has a maximum value, decreasing during the first week of life by almost 2 times. Measurement of NT-proBNP concentration can be used in newborns with CHD and HF risk in the neonatal period. The assessment of NT-proBNP concentration in newborns in dynamics can be an additional criterion in assessing the therapy effectiveness.

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  • 1. Version of Record от 2020-05-01

Метаданные

Об авторах
  • I. Maslennikova
    Sechenov First Moscow State Medical University, Nationa Medical Research Center Obsterics, Gynecology and Perinatology the name of Academician V.I. Kulakov
  • E. Bockeriya
    Sechenov First Moscow State Medical University, Nationa Medical Research Center Obsterics, Gynecology and Perinatology the name of Academician V.I. Kulakov
  • T. Ivanetc
    Nationa Medical Research Center Obsterics, Gynecology and Perinatology the name of Academician V.I. Kulakov
  • I. Kazantseva
    Nationa Medical Research Center Obsterics, Gynecology and Perinatology the name of Academician V.I. Kulakov
  • D. Degtyarev
    Sechenov First Moscow State Medical University, Nationa Medical Research Center Obsterics, Gynecology and Perinatology the name of Academician V.I. Kulakov
Название журнала
  • Pediatriya - Zhurnal im G.N. Speranskogo
Том
  • 99
Выпуск
  • 3
Страницы
  • 16-22
Номер гранта
  • undefined
Тип документа
  • journal article
Тип лицензии Creative Commons
  • CC BY
Правовой статус документа
  • Свободная лицензия
Источник
  • scopus