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 journalArticlepeer-review


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
Issue number3
Publication statusPublished - Sept 2008
Event28th Annual Meeting of the Society for Maternal–Fetal Medicine - Dallas (TX), United States
Duration: 28 Jan 20082 Feb 2008


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


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