Rediscover the predictive capacity of B-type natriuretic peptide applied to neonatal ventricular supertachycardia

Abstract

Abstract Background Supraventricular tachycardia (SVT) is one of the most common non-benign arrhythmias in neonates that could lead to cardiac decompensation. This study investigated early risk factors of acute heart failure (AHF) secondary to SVT in neonates, and explored their value on guiding the selection of efficient anti-arrhythmic treatment. Methods A total of 43 newborns with SVT diagnosed and treated between January 2017 and December 2022 were analyzed. According to the presence of AHF after initial restoring SVT to sinus rhythm, newborns were divided into SVT with AHF group and SVT without AHF group, and the clinical data and anti-arrhythmic therapies were analyzed. Risk factors of AHF secondary to SVT in neonates were determined by logistic regression. The cut-off value for predictors of AHF secondary to SVT and demanding of a second line anti-arrhythmic treatment was determined by receiver operating characteristic curve analysis. Results Time to initial control of tachycardia > 24h, hyperkalemia, anemia, plasma B-type natriuretic peptide (BNP) were risk factors of AHF secondary to SVT in neonates. BNP exhibited AUC of 0.804 in predicting AHF, and BNP > 2460.5pg/ml (OR 2.281, 95% CI 1.270 ~ 45.399, P = 0.026) was an independent predictor yielded sensitivity of 70.59% and specificity of 84.62%. The neonates with BNP > 2460.5pg/ml (37.5% versus 7.4%, P = 0.037) had a higher demand for a second line anti-arrhythmic treatment to terminate SVT, and the sensitivity and and specificity for BNP in predicting were 75.0%, 71.4%, respectively. Conclusions BNP could be used to predict an incident of AHF secondary to SVT and a demand of second line anti-arrhythmic treatment for terminating SVT hastily to prevent decompensation in neonates.