The Significance Of NT-proBNP And Tei Index Evaluating The Right Ventricular Function In Neonates With Hypoxic Pulmonary Hypertension

Objective To determine the association between NT-proBNP and Tei index innewborns with hypoxic pulmonary,and their values on evaluating the right ventricularfunction.Methods Between June2012and November2013, we studied72newborns withperinatal hypoxia,who were admitted to the neonate intensive care unit(NICU) ofChenzhou NO.1hospital affiliated to University of South China. All of72newbornswere divided into hypoxic pulmonary hypertension(HPH) group(46newborns) andnon-HPH group(26newborns) on the basis of HPH. The group of HPH was groupedinto parts of mild (20newborns)、moderate (18newborns) and severe（8newborns）according to the level of PASP within the first day of life, while in the7th day,Thegroup of HPH was divided into two group in the light of whether PASP came tonormal.22cases of ordinary neonates without perinatal hypoxia history, checked inhospital in the corresponding period, were selected to be control group. All objectsshould be examined with the dates of PASP、right ventricular Tei index and rightventricular ejection fraction (RVEF), tricuspid peak early diastolic (E peak), peaklate diastolic (A peak),and in the first day after birth,however, the HPH group waschecked in the7thdays after birth. The whole targets’ venous blood were collectedin the sake of determining the serum concentration of NT-proBNP, within one hourafter Ultrasonography. Contrastive analysis should be carried out between and withingroup related to right ventricular ejection fraction (RVEF)、the value of E/A、rightventricular Tei index and the serum concentration of NT-proBNP. Compared therecovered and the unrecovered in the7thday after birth with indicators in the first dayafter birth, and analyze the relevance between the serum concentration of NT-proBNPand right ventricular Tei index, the correlation of the serum concentration of NT-proBNP、right ventricular Tei and PASP was included.Results1In the first day after birth, RVEF and the value of E/A in moderate PAH groupand severe PAH group were lower than the control group and non-HPH group, whichhad statistically significant difference（P＜0.05); there was statistically significantdifference as the moderate PAH group’s were higher than the severe group’s（P＜0.05）；there were no difference between mild group and non-HPH group（P＞0.05）.2In the first day after birth, the serum concentration of NT-proBNP and Tei index inobservational group all exceeded the control group, and it produced statisticallysignificant difference（P＜0.05). Due to that moderate HPH group’s and severe HPHgroup’s are higher than non-HPH group’s and mild group’s, the difference wasstatistically significant（P＜0.05）. There was statistically significant difference, onaccount that sever group’s was higher than moderate group（P＜0.05）.No statisticallysignificant difference was obtained, when we did contrast of non-HPH group’s andmild group’s（P＞0.05）.3In the7thth day after birth, the RVEF and the value of E/A were higher than that inthe first day after birth, while Tei index and the serum concentration of NT-proBNPwere lower, and the statistically significant differences both made sense（P＜0.05）.Compared with the relating data in the first day after birth, Tei index and theserum concentration NT-proBNP decreased while RVEF and the value of E/A areincreased in the group with unrecovered HPH; the former brought statisticallysignificant differences（P＜0.05）, meanwhile the latter didn’t （P＞0.05）.4The RV-Tei index had a positive correlation with the serum concentration ofNT-proBNP（r=0.826，P=0.000）and PASP （r=0.555，P=0.000）; the serumconcentration of NT-proBNP had a positive correlation with PASP（r=0.504，P=0.000）.Conclusion The serum concentration of NT-proBNP and RV-Tei index, increasedin neonates suffered from perinatal hypoxia and in positive correlation with PASP,were positively related. It indicated that there existed the dysfunction of right ventricular closely connecting with PASP in neonates suffered from perinatal hypoxia.With the improvement of the disease, PASP came down,resulting in the decrease ofthe serum concentration of NT-proBNP and RV-Tei index. In contrast with traditionalindex evaluating the right ventricular by ultrasonography, such as RVEF、the value ofE/A, RV-Tei index was more sensitive.