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

Fàtima Crispi, Edgar Hernandez-Andrade, Maurice M.A.L. Pelsers, Walter Plasencia, Jesus Andres Benavides-Serralde, Elisenda Eixarch, Ferdinand le Noble, Asif Ahmed, Jan F.C. Glatz, Kypros H. Nicolaides, Eduard Gratacos

Research output: Contribution to journalArticle

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.
Original languageEnglish
Pages (from-to)254.e1-254.e8
Number of pages8
JournalAmerican Journal of Obstetrics and Gynecology
Volume199
Issue number3
DOIs
Publication statusPublished - Sep 2008
Event28th Annual Meeting of the Society for Maternal–Fetal Medicine - Dallas (TX), United States
Duration: 28 Jan 20082 Feb 2008

Fingerprint

Fetus
Growth
Troponin I
Brain Natriuretic Peptide
Cardiac Output
C-Reactive Protein
Gestational Age
Umbilical Arteries
Fetal Blood
Proteins

Keywords

  • cardiac function
  • Doppler ultrasound
  • heart fatty acid–binding protein
  • intrauterine growth restriction
  • myocardial damage

Cite this

Crispi, F., Hernandez-Andrade, E., Pelsers, M. M. A. L., Plasencia, W., Benavides-Serralde, J. A., Eixarch, E., ... Gratacos, E. (2008). Cardiac dysfunction and cell damage across clinical stages of severity in growth-restricted fetuses. American Journal of Obstetrics and Gynecology, 199(3), 254.e1-254.e8. https://doi.org/10.1016/j.ajog.2008.06.056
Crispi, Fàtima ; Hernandez-Andrade, Edgar ; Pelsers, Maurice M.A.L. ; Plasencia, Walter ; Benavides-Serralde, Jesus Andres ; Eixarch, Elisenda ; le Noble, Ferdinand ; Ahmed, Asif ; Glatz, Jan F.C. ; Nicolaides, Kypros H. ; Gratacos, Eduard. / Cardiac dysfunction and cell damage across clinical stages of severity in growth-restricted fetuses. In: American Journal of Obstetrics and Gynecology. 2008 ; Vol. 199, No. 3. pp. 254.e1-254.e8.
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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.",
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Crispi, F, Hernandez-Andrade, E, Pelsers, MMAL, Plasencia, W, Benavides-Serralde, JA, Eixarch, E, le Noble, F, Ahmed, A, Glatz, JFC, Nicolaides, KH & Gratacos, E 2008, 'Cardiac dysfunction and cell damage across clinical stages of severity in growth-restricted fetuses', American Journal of Obstetrics and Gynecology, vol. 199, no. 3, pp. 254.e1-254.e8. https://doi.org/10.1016/j.ajog.2008.06.056

Cardiac dysfunction and cell damage across clinical stages of severity in growth-restricted fetuses. / Crispi, Fàtima; Hernandez-Andrade, Edgar; Pelsers, Maurice M.A.L.; Plasencia, Walter; Benavides-Serralde, Jesus Andres; Eixarch, Elisenda; le Noble, Ferdinand; Ahmed, Asif; Glatz, Jan F.C.; Nicolaides, Kypros H.; Gratacos, Eduard.

In: American Journal of Obstetrics and Gynecology, Vol. 199, No. 3, 09.2008, p. 254.e1-254.e8.

Research output: Contribution to journalArticle

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T1 - Cardiac dysfunction and cell damage across clinical stages of severity in growth-restricted fetuses

AU - Crispi, Fàtima

AU - Hernandez-Andrade, Edgar

AU - Pelsers, Maurice M.A.L.

AU - Plasencia, Walter

AU - Benavides-Serralde, Jesus Andres

AU - Eixarch, Elisenda

AU - le Noble, Ferdinand

AU - Ahmed, Asif

AU - Glatz, Jan F.C.

AU - Nicolaides, Kypros H.

AU - Gratacos, Eduard

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N2 - 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.

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KW - Doppler ultrasound

KW - heart fatty acid–binding protein

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Crispi F, Hernandez-Andrade E, Pelsers MMAL, Plasencia W, Benavides-Serralde JA, Eixarch E et al. Cardiac dysfunction and cell damage across clinical stages of severity in growth-restricted fetuses. American Journal of Obstetrics and Gynecology. 2008 Sep;199(3):254.e1-254.e8. https://doi.org/10.1016/j.ajog.2008.06.056