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322 Could Cardiac Enzymes and the Carinal Angle Measurement be Used as Indicators of Hemodynamically Significant Patent Ductus Arteriosus?
  1. E Rahimov1,
  2. Y Ergul2,
  3. Z Ince3,
  4. E Yekeler4,
  5. S Yildirim3,
  6. B Omer5,
  7. A Coban3
  1. 1Children’s Health and Diseases
  2. 2Pediatric Cardiology
  3. 3Neonatology
  4. 4Pediatric Radiology
  5. 5Biochemistry, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey

Abstract

Aim In this blind prospective study, we aimed to examine the utility of cardiac enzymes and the carinal angle measurement in detecting hemodynamically significant patent ductus arteriosus (PDA), evaluating response to treatment and follow-up in preterm infants.

Patients and Methods We evaluated 39 preterm infants < 32 gestational weeks. Every patient had an echocardiogram (ECHO) taken on postnatal day 3 by a cardiologist blinded to clinical findings and laboratory results. ECHO was repeated when necessary. N-terminal pro-brain natriuretic peptide (NT-proBNP), cardiac troponin T (cTnT), creatine kinase MB isoenzyme (CK-MB) levels were measured on postnatal days 0, 3 and 7. The carinal angle on chest radiographs taken on the same days was measured. Those with PDA deemed hemodynamically significant based on ECHO were referred to as ehsPDA group. Those in this group who also had clinical signs were referred as sPDA subgroup.

Results The mean gestational age was 28.7 weeks; mean birth weight was 1120 g. Initial ECHO showed PDA in 27 patients (69.2%), 11 of which (40.7%) had ehsPDA. Eight patients had sPDA. When the ehsPDA and sPDA groups were compared to the rest, no statistically significant difference was found in terms of the carinal angle, NT-proBNP and cTnT. CK-MB levels were significantly low in ehsPDA and sPDA groups on postnatal days 3 and 7 (p=0.017, p=0.026, respectively).

Conclusion NT-proBNP, cTnT, CK-MB and the carinal angle were not found useful in detection and follow-up of hemodynamically significant PDA.

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