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Open AccessArticle

Left Ventricular Dysfunction and Plasmatic NT-proBNP Are Associated with Adverse Evolution in Respiratory Syncytial Virus Bronchiolitis

1
Paediatric Cardiology Division, Puerta del Mar University Hospital, 11009 Cadiz, Spain
2
Biomedical Research and Innovation Institute of Cadiz (INiBICA), Research Unit, Puerta del Mar University Hospital, University of Cadiz, 11009 Cadiz, Spain
3
Paediatric Nephrology Division, Puerta del Mar University Hospital, 11009 Cadiz, Spain
4
Neonatology Division, Puerta del Mar University Hospital, 11009 Cadiz, Spain
*
Author to whom correspondence should be addressed.
Diagnostics 2019, 9(3), 85; https://doi.org/10.3390/diagnostics9030085
Received: 27 June 2019 / Revised: 25 July 2019 / Accepted: 26 July 2019 / Published: 27 July 2019
(This article belongs to the Special Issue Diagnosis and Management of Pediatric Diseases)
Aim: To investigate whether the presence of left ventricular myocardial dysfunction (LVMD) assessed by Tei index (LVTX) impacts the outcomes of healthy infants with Respiratory Syncytial Virus Bronchiolitis (RSVB). To explore whether N-terminal pro-B-type natriuretic peptide (NT-proBNP) increases the accuracy of traditional clinical markers in predicting the outcomes. Methods: A single-centre, prospective, cohort study including healthy infants aged 1–12 months old admitted for RSVB between 1 October 2016 and 1 April 2017. All patients underwent clinical, laboratory and echocardiographic evaluation within 24 h of admission. Paediatric intensive care unit (PICU) admission was defined as severe disease. Results: We enrolled 50 cases of RSVB (median age of 2 (1–6.5) months; 40% female) and 50 age-matched controls. We observed higher values of LVTX in infants with RSVB than in controls (0.42 vs. 0.36; p = 0.008). Up to nine (18%) children presented with LVMD (LVTX > 0.5), with a higher incidence of PICU admission (89% vs. 5%; p < 0.001). The diagnostic performance of NT-proBNP in predicting LVMD was high (area under the receiver operator characteristic curve (AUC) 0.95, CI 95% 0.90–1). The diagnostic yield of the predictive model for PICU admission that included NT-proBNP was excellent (AUC 0.945, CI 95% 0.880–1), and significantly higher than the model without NT-proBNP (p = 0.026). Conclusions: LVMD could be present in healthy infants with RSVB who develop severe disease. NT-proBNP seems to improve traditional clinical markers for outcomes. View Full-Text
Keywords: respiratory syncytial virus; NT-proBNP; echocardiography; pulmonary hypertension; myocardial dysfunction; tissue doppler imaging; Tei index; biomarkers; infants respiratory syncytial virus; NT-proBNP; echocardiography; pulmonary hypertension; myocardial dysfunction; tissue doppler imaging; Tei index; biomarkers; infants
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Rodriguez-Gonzalez, M.; Perez-Reviriego, A.A.; Castellano-Martinez, A.; Lubian-Lopez, S.; Benavente-Fernandez, I. Left Ventricular Dysfunction and Plasmatic NT-proBNP Are Associated with Adverse Evolution in Respiratory Syncytial Virus Bronchiolitis. Diagnostics 2019, 9, 85.

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