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Journal of the Korean Society of Neonatology 1999;6(1):43-51.
Published online January 1, 2001.
Plasma Atrial Natriuretic Peptide and Hemodynamic Change of Patent Ductus Arteriosus in Healthy Low Birth Weight Infants without Clinical Evidence of PDA.
Byoung Min Choi, Jong Kwnag Lee, Hae Won Cheon, Kee Hwan Yoo, Young Sook Hong, Joo Won Lee, Soon Kyum Kim
1Department of Pediatrics, College of Medicine, Korea University, Seoul.
2Department of Pediatrics, Shin Women's Hospital, Anyang, Korea.
Abstract
PURPOSE
Atrial natriuretic peptide(ANP) is a hormone with strong vasodilating, diu-retic and natriuretic properties. The aim of this study was to clarify the interrelationship of ANP secretion and hemodynamic changes of patent ductus arteriosus(PDA) in healthy preterm and fullterm infants without clinical evidence of PDA. METHODS: Thirteen preterm infants and six full term infants who did not develop clinical evidence of PDA were studied at 6 hr, 12 hr, 24 hr, 3rd day and 4th day after birth, until their PDAs closed spontaneously. Plasma ANP concentrations and the hemodynamic changes of PDA were rneasured.
RESULTS
The ANP concentrations of all infants increased from 34.1+/-10.9 pg/ml at 6 hr to 120.5+/-18.8 pg/ml at 12 hr, and declined thereafter gradually to 74.2+/-12.7 pg/ml at 4th day. The ANP concentrations, LA/Ao ratio and LAV decreased after ductal closure. The pulmonary flow velocity(PFV) of PDA correlated with ANP concentration in preterm infants(r=0.23, P<0.05). LA/Ao ratio correlated with ANP contration in all infants (r=0.28, P<0.05), especially in preterm infants(r=0.46, P<0.01 during 12 hr and 4th day after birth. LAV correlated with the ANP concentrations in preterm infants during 12 hr and 4th day after birth(r=0.34, P<0.05).
CONCLUSION
The changes of ANP concentrations are probably due to the changes of the left-to-right shunt of PDA with left atrial stretch. Reduction of the ANP concentrations may serve as an indicator of spontaneous closure of PDA. Therefore ANP measurement may be useful in deciding the need and the timing of medical and surgical managernent of newbom infants without clinical evidence of PDA.
Key Words: Plasma atrial natriuretic peptide, Hemodynamic change, Patent ductus arteriosus, Low birth weight infant


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