Predictive Values of Echocardiographic Parameters Combined with Platelet Indices for the Sustained Opening of Hemodynamically Significant Patent Ductus Arteriosus in Preterm Infants

Patent ductus arteriosus (PDA) is a prevalent congenital cardiac anomaly in neonates. It is characterized by substantial hemodynamic alterations owing to large shunt volumes and is referred to as hemodynamically significant PDA (hsPDA). hsPDA incidence is notably elevated in preterm infants, who are consequently at increased risk of severe organ complications and mortality. This study aimed to evaluate the predictive value of early echocardiographic parameters combined with platelet indices for predicting the persistence of hsPDA at 14 days postnatally. We conducted a retrospective analysis of clinical data from 120 very-low-birth-weight infants admitted to Zhongshan People's Hospital between May 2020 and August 2023, dividing them into the hsPDA (n = 46) and non-hsPDA (n = 74) groups based on echocardiography and clinical outcomes at 14 days. Univariate and multivariate logistic regression analyses identified the PDA diameter and left atrium-to-aorta ratio (LA/AO) as independent risk factors for persistent hsPDA, whereas the platelet distribution width (PDW) index emerged as a protective factor. Receiver operating characteristic curve analysis indicated that the area under the curve (AUC) values for the parameters of PDA diameter (0.7769, with a cut-off value of 2.81), LA/AO ratio (0.8964, with a cut-off value of 1.465), and PDW (0.7521, with a cut-off value of 15.58) were calculated. Meanwhile, the combination of these three parameters achieved the highest diagnostic efficiency (AUC = 0.9222). In summary, echocardiographic parameters, particularly the PDA diameter and LA/AO ratio, in conjunction with the PDW index, are effective predictors of persistent hsPDA in preterm infants. These findings offer valuable insights for the early clinical diagnosis of this condition.