B-natriuretic peptide serum levels in neonates with persistent pulmonary hypertension

Abstract

Abstract Background Better management of persistent pulmonary hypertension of neonates (PPHN) required new markers that can predict the response of patient to treatment and thus influence the medical decision to avoid short-term and long-term adverse effects. Hence, we aimed to evaluate B-natriuretic peptide (BNP) serum levels in neonates with PPHN and to correlate its levels with disease severity and response to treatment. Patients and methods The study included 60 neonates (30 PPHN patients and 30 healthy subjects). BNP was assessed, using the ELISA technique, at admission and after 4 days of treatment. Results Initial serum BNP levels were significantly higher in patients compared to controls (p < 0.001). Patients with mild severity showed lower BNP levels compared to patients with moderate severity, while patients with moderate severity showed decreased levels in comparison to severe cases (p < 0.001). The group of patients who showed remission after 4 days of treatment had lower pre-treatment and post-treatment BNP levels, compared to patients who showed incomplete remission. Initial levels of BNP showed strong positive correlations with pulmonary artery pressure (PAP) and oxygenation index (OI) before treatment (r = 0.9, p < 0.001 and r = 0.85, p = 0.001), while BNP after treatment showed moderate positive correlations with PAP before treatment (r = 0.6, p = 0.001) and OI before treatment (r = 0.6, p = 0.001). Analysis of the ROC curve revealed an AUC of 0.83with CI = 0.7–0.98 and p = 0.003. Conclusions BNP may play a role in the pathogenesis of PPHN, and BNP serum level can be used as a marker to detect disease severity and predict response to treatment.