Cardiac dysfunction and cell damage across clinical stages of severity in growth-restricted fetuses

Item Type:	Article
Title:	Cardiac dysfunction and cell damage across clinical stages of severity in growth-restricted fetuses
Creators Name:	Crispi, F. and Hernandez-Andrade, E. and Pelsers, M.M. and Plasencia, W. and Benavides-Serralde, J.A. and Eixarch, E. and le Noble, F. and Ahmed, A. and Glatz, J.F. and Nicolaides, K.H. and Gratacos, E.
Abstract:	OBJECTIVE: The purpose of this study was to assess cardiac function and cell damage in intrauterine growth-restricted (IUGR) fetuses across clinical Doppler stages of deterioration. STUDY DESIGN: One hundred twenty appropriate-for-gestational-age and 81 IUGR fetuses were classified in stages 1/2/3 according umbilical artery present/absent/reversed end-diastolic blood flow, respectively. Cardiac function was assessed by modified-myocardial performance index, early-to-late diastolic filling ratios, cardiac output, and cord blood B-type natriuretic peptide; myocardial cell damage was assessed by heart fatty acid-binding protein, troponin-I, and high-sensitivity C-reactive protein. RESULTS: Modified-myocardial performance index, blood B-type natriuretic peptide, and early-to-late diastolic filling ratios were increased in a stage-dependent manner in IUGR fetuses, compared with appropriate-for-gestational-age fetuses. Heart fatty acid-binding protein levels were higher in IUGR fetuses at stage 3, compared with control fetuses. Cardiac output, troponin-I, and high-sensitivity C-reactive protein did not increase in IUGR fetuses at any stage. CONCLUSION: IUGR fetuses showed signs of cardiac dysfunction from early stages. Cardiac dysfunction deteriorates further with the progression of fetal compromise, together with the appearance of biochemical signs of cell damage.
Keywords:	Cardiac Function, Doppler Ultrasound, Heart Fatty Acid–Binding Protein, Intrauterine Growth Restriction, Myocardial Damage, Biological Markers, C-Reactive Protein, Cardiac Output, Fetal Blood, Fetal Growth Retardation, Fetal Heart, Myocardium, Pregnancy, Pulsatile Flow, Regional Blood Flow, Risk Factors, Smoking, Troponin I, Doppler Ultrasonography, Prenatal Ultrasonography, Umbilical Arteries
Source:	American Journal of Obstetrics and Gynecology
ISSN:	0002-9378
Publisher:	Elsevier
Volume:	199
Number:	3
Page Range:	254.e1-254.e8
Date:	September 2008
Official Publication:	https://doi.org/10.1016/j.ajog.2008.06.056
PubMed:	View item in PubMed

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