Abstract | BACKGROUND: METHODS AND RESULTS: In 48 fetuses with placental insufficiency, umbilical artery blood was obtained at delivery for assessment of N-terminal peptide of proatrial natriuretic peptide (NT-proANP) and cardiac troponin-T (cTnT). Group 1 fetuses (n=12) had normal NT-proANP and cTnT serum concentrations. Group 2 fetuses (n=25) showed increased NT-proANP (>1145 pmol/L) and normal cTnT values. Group 3 fetuses (n=11) had increased NT-proANP and cTnT (>0.10 ng/mL) levels. The ultrasonographic parameters of fetal cardiovascular function were compared between the groups. Pulsatility indices for veins of the ductus venosus, left hepatic vein, and inferior vena cava correlated significantly with NT-proANP levels. In group 3, ductus venosus, left hepatic vein, and inferior vena cava pulsatility indices for veins were higher (P<0.01) than in groups 1 and 2. The proportion of left ventricular cardiac output of combined cardiac output was greater (P<0.05) and that of right ventricle was smaller (P<0.05) in group 3 than in group 2. In group 3, tricuspid regurgitation was noted most often (P<0.05), and right ventricular fractional shortening was less (P<0.01) than in group 2. CONCLUSIONS: Pulsatility in human fetal systemic veins correlated significantly with the cardiac secretion of ANP. Fetuses with myocardial damage demonstrate increased systemic venous pressure, a change in the distribution of cardiac output toward the left ventricle, and a rise in right ventricular afterload.
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Authors | Kaarin Mäkikallio, Olli Vuolteenaho, Pentti Jouppila, Juha Räsänen |
Journal | Circulation
(Circulation)
Vol. 105
Issue 17
Pg. 2058-63
(Apr 30 2002)
ISSN: 1524-4539 [Electronic] United States |
PMID | 11980685
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Biomarkers
- N-terminal proatrial natriuretic peptide
- Protein Precursors
- Troponin T
- Atrial Natriuretic Factor
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Topics |
- Adult
- Atrial Natriuretic Factor
(blood)
- Biomarkers
(blood)
- Coronary Circulation
- Cross-Sectional Studies
- Echocardiography, Doppler
(methods)
- Female
- Fetal Heart
(diagnostic imaging, physiopathology)
- Hemodynamics
- Humans
- Myocardial Contraction
- Placental Insufficiency
(diagnosis, diagnostic imaging, physiopathology)
- Pregnancy
- Protein Precursors
(blood)
- Troponin T
(blood)
- Umbilical Arteries
(chemistry)
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