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Title: | Cord blood cardiovascular biomarkers in left-sided congenital heart disease. |
Author: | Soveral, Iris Guirado, Laura Escobar Diaz, María C. Alcaide, María José Martínez Crespo, Josep M. (Josep Maria) V Rodríguez-Sureda Bijnens, Bart Antolín, Eugenia Llurba Olivé, Elisa Bartha, José Luis Gómez, Olga Crispi Brillas, Fàtima |
Keywords: | Malalties del cor Ecocardiografia Fetus Cordó umbilical Sang fetal Marcadors bioquímics Factors de creixement Heart diseases Echocardiography Fetus Umbilical cord Fetal blood Biochemical markers Growth factors |
Issue Date: | 30-Nov-2022 |
Publisher: | MDPI |
Abstract: | Fetal echocardiography has limited prognostic ability in the evaluation of left-sided congenital heart defects (left heart defects). Cord blood cardiovascular biomarkers could improve the prognostic evaluation of left heart defects. A multicenter prospective cohort (2013-2019) including fetuses with left heart defects (aortic coarctation, aortic stenosis, hypoplastic left heart, and multilevel obstruction (complex left heart defects) subdivided according to their outcome (favorable vs. poor), and control fetuses were evaluated in the third trimester of pregnancy at three referral centers in Spain. Poor outcome was defined as univentricular palliation, heart transplant, or death. Cord blood concentrations of N-terminal precursor of B-type natriuretic peptide, Troponin I, transforming growth factor β, placental growth factor, and soluble fms-like tyrosine kinase-1 were determined. A total of 45 fetuses with left heart defects (29 favorable and 16 poor outcomes) and 35 normal fetuses were included, with a median follow-up of 3.1 years (interquartile range 1.4-3.9). Left heart defects with favorable outcome showed markedly increased cord blood transforming growth factor β (normal heart median 15.5 ng/mL (6.8-21.4) vs. favorable outcome 51.7 ng/mL (13.8-73.9) vs. poor outcome 25.1 ng/mL (6.9-39.0), p = 0.001) and decreased placental growth factor concentrations (normal heart 17.9 pg/mL (13.8-23.9) vs. favorable outcome 12.8 pg/mL (11.7-13.6) vs. poor outcome 11.0 pg/mL (8.8-15.4), p < 0.001). Poor outcome left heart defects had higher N-terminal precursor of B-type natriuretic peptide (normal heart 508.0 pg/mL (287.5-776.3) vs. favorable outcome 617.0 pg/mL (389.8-1087.8) vs. poor outcome 1450.0 pg/mL (919.0-1645.0), p = 0.001) and drastically reduced soluble fms-like tyrosine kinase-1 concentrations (normal heart 1929.7 pg/mL (1364.3-2715.8) vs. favorable outcome (1848.3 pg/mL (646.9-2313.6) vs. poor outcome 259.0 pg/mL (182.0-606.0), p < 0.001). Results showed that fetuses with left heart defects present a distinct cord blood biomarker profile according to their outcome. |
Note: | Reproducció del document publicat a: https://doi.org/10.3390/jcm11237119 |
It is part of: | Journal of Clinical Medicine, 2022, vol. 11, num. 23, p. 7119-7131 |
URI: | http://hdl.handle.net/2445/193710 |
Related resource: | https://doi.org/10.3390/jcm11237119 |
ISSN: | 2077-0383 |
Appears in Collections: | Articles publicats en revistes (Cirurgia i Especialitats Medicoquirúrgiques) Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer) |
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