Why the study?
Do pregnant women with multifetal pregnancies and/or hypertensive disorders exhibit greater changes in cardiac biomarkers compared to those with normotensive singleton pregnancies?
Do pregnant women with multifetal pregnancies and/or hypertensive disorders exhibit greater changes in cardiac biomarkers compared to those with normotensive singleton pregnancies?
Pregnant women with multifetal pregnancies or hypertensive disorders have markedly increased hs-TnI and NT-proBNP levels, suggesting these biomarkers could help select candidates for echocardiography to screen for peripartum cardiomyopathy.
May support targeted echocardiography in high-risk pregnancies; hypothesis-generating and requires prospective validation before practice change.
AIMS: Echocardiography is necessary for the diagnosis of peripartum cardiomyopathy (PPCM). Multifetal pregnancies (MFP) and hypertensive disorders (HD) are prominent risk factors for PPCM. To determine which blood variables exhibit greater change in a late stage of pregnancy in women with MFP and/or HD compared with women with normotensive singleton pregnancies. METHODS AND RESULTS: Serum levels of six variables-high-sensitive troponin I (hs-TnI), N-terminal fragment of precursor protein brain-type natriuretic peptide (NT-proBNP), myoglobin, creatine kinase-myocardial band, ferritin, and prolactin-were compared between 29 women with MFP (n = 13) and/or HD (n = 18) and 100 women with normotensive singleton pregnancies (control group). None of 129 women developed PPCM. All variables increased significantly peripartum in both groups. In 29 women with MFP and/or HD, the elevated hs-TnI and NT-proBNP levels (median) were significantly higher compared with the control group (5.4 vs. 3.7 pg/mL for hs-TnI with P = 0.002, 185 vs. 68 pg/mL for NT-proBNP with P = 0.007), and the prevalence rate of more than 90th percentile value specific for the 129 women was significantly more frequent for hs-TnI (>12.2 pg/mL; 31% [9/29] vs. 4.0% [4/100], P < 0.001) and tended to be more frequent for NT-proBNP (>342 pg/mL; 21% [6/29] vs. 7.0%, P = 0.072). CONCLUSIONS: Both hs-TnI and NT-proBNP were likely to increase markedly in women with MFP and/or HD. The combination of hs-TnI and NT-proBNP may contribute to better selection of candidates for echocardiography.
No takes yet. Share an insight, caveat, or question.
Umazume et al. (2015) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: