To the Editor.—

We read with great interest “Brain-Type Natriuretic Peptide in the Diagnosis and Management of Persistent Pulmonary Hypertension of the Newborn” by Reynolds et al. The authors suggest the blood level of brain-type natriuretic peptide (BNP) as a marker that can be used as an adjunct parameter to differentiate newborns with persistent pulmonary hypertension from other noncardiac causes of respiratory distress. This information might be particularly useful in deciding appropriate treatment and planning early transfer to centers with echocardiographic facilities. Although hypothesized in their discussion, the study by Reynolds et al did not investigate if cardiac anomalies resulting in ventricular stress in neonates might also induce elevated blood levels of BNP. It is worth clarifying this aspect, because these patients could require a different therapeutic approach than infants with persistent pulmonary hypertension.

It is interesting to note that we currently are performing a clinical study aimed...

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