Key result
Severe fetal cardiovascular compromise with abnormal umbilical artery and ductus venosus velocimetry was associated with a higher incidence of abnormal NT-proBNP levels (92.9% vs 30.8%).
Why the study?
Is umbilical artery NT-proBNP concentration associated with the severity of cardiovascular compromise in human fetuses with intrauterine growth restriction?
Cross-Sectional (n=91)
Is umbilical artery NT-proBNP concentration associated with the severity of cardiovascular compromise in human fetuses with intrauterine growth restriction?
Absolute Event Rate: 92.9% vs 30.8%
p-value: p=<0.05
In human fetal growth restriction, elevated umbilical artery NT-proBNP concentrations correlate with increased cardiac afterload and abnormal ductus venosus blood velocity waveforms, serving as a biomarker for fetal cardiovascular compromise.
NT-proBNP elevation signals worsening fetal hemodynamics in IUGR; leaves open its role in guiding management.
OBJECTIVE: To test our hypothesis that human fetal N-terminal peptide of proB-type natriuretic peptide (NT-proBNP) secretion is increased in proportion to the severity of fetal cardiovascular compromise in intrauterine growth restriction. METHODS: This prospective cross-sectional study consisted of 42 growth-restricted fetuses who underwent Doppler ultrasonographic examination of cardiovascular hemodynamics within 7 days before delivery. Group 1 fetuses (n = 13) had normal umbilical artery (UA) velocimetry. Group 2 fetuses (n = 15) had abnormal UA and normal ductus venosus (DV) velocimetry. In Group 3 fetuses (n = 14), both UA and DV velocimetries were abnormal. At delivery, an UA blood sample was obtained for assessment of NT-proBNP. Normal values for UA NT-proBNP were determined in 49 neonates (control group) with uncomplicated pregnancy and delivery. RESULTS: Group 3 fetuses demonstrated greater (P < 0.05) UA and descending aorta pulsatility indices (PIs) and greater DV, left hepatic vein (LHV) and inferior vena cava PIs for veins (PIVs) than fetuses in Groups 1 and 2. Weight-indexed cardiac outputs and ventricular ejection forces were similar among the groups. Group 3 fetuses had higher (P < 0.05) UA NT-proBNP concentration than fetuses in Groups 1 and 2. In the control group, the 95(th) percentile value of UA NT-proBNP was 518 pmol/L. In Group 3, 13/14 neonates demonstrated abnormal UA NT-proBNP levels. The corresponding incidences were 4/13 and 7/15 in Groups 1 and 2. Significant positive correlations were found between UA, DV and LHV PIVs and UA NT-proBNP concentrations. CONCLUSION: In human fetal growth restriction, increased cardiac afterload and pulsatility in DV blood velocity waveform pattern are associated with elevated UA NT-proBNP concentrations.
No takes yet. Share an insight, caveat, or question.
Girsén et al. (2007) conducted a cross-sectional in Intrauterine growth restriction (n=91). Abnormal umbilical artery and ductus venosus velocimetry vs. Normal umbilical artery velocimetry was evaluated on Abnormal umbilical artery NT-proBNP levels (p=<0.05). Severe fetal cardiovascular compromise with abnormal umbilical artery and ductus venosus velocimetry was associated with a higher incidence of abnormal NT-proBNP levels (92.9% vs 30.8%).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: