scholarly journals Association of peripartum troponin I levels with left ventricular relaxation in women with hypertensive disorders of pregnancy

Open Heart ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. e000829
Author(s):  
Takeshi Umazume ◽  
Satoshi Yamada ◽  
Takahiro Yamada ◽  
Satoshi Ishikawa ◽  
Itsuko Furuta ◽  
...  
Keyword(s):  
Natriuretic Peptide ◽  
Troponin I ◽  
Vena Cava ◽  
High Sensitivity ◽  
Left Ventricular ◽  
Hypertensive Disorders Of Pregnancy ◽  
Third Trimester ◽  
Receiver Operating Characteristic Curves ◽  
The Third ◽  
Hypertensive Disorders

ObjectiveWomen with hypertensive disorders of pregnancy (HDP) show elevated risk of heart failure despite decreased circulating plasma volume compared with those with normotensive control pregnancies (NCP). This study was performed to better characterise the heart in women with HDP and determine whether high-sensitivity troponin I (hs-TnI) around childbirth predicts reduced left ventricular (LV) relaxation at 1 month postpartum.MethodsEchocardiography was performed longitudinally during the first, second and third trimesters and immediately postpartum within 1 week and 1 month postpartum in 24 women with HDP, with simultaneous determination of blood variables in comparison with 51 women with NCP.ResultsCompared with NCP, HDP showed greater antepartum left atrial (LA) volume, LV mass and inferior vena cava (IVC) diameter, higher peripartum brain natriuretic peptide/N-terminal pro–B-type natriuretic peptide and hs-TnI with the highest value immediately postpartum, and lower early diastolic mitral annular velocity (e') during pregnancy/postpartum. In analyses of data on HDP and NCP, hs-TnI at the third trimester as well as that immediately postpartum was negatively correlated with later e' at 1 month postpartum. The areas under the receiver operating characteristic curves were 0.82 and 0.81 for hs-TnI at the third trimester and immediately postpartum, respectively, in the prediction of reduced LV relaxation at 1 month postpartum.ConclusionReduced LV diastolic function and decreased splanchnic blood reservoir may contribute to the increased third trimester IVC diameter and LA volume in women with HDP. The rise in hs-TnI around childbirth was associated with poor LV relaxation ability at 1 month postpartum.

Abstract P234: Hypertensive Disorders Of Pregnancy And Increased Levels Of Cardiac Troponin I After Delivery

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Takao Kato ◽  
Eri Muta ◽  
Moriaki Inoko
Keyword(s):  
Pregnant Women ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Normal Population ◽  
Laboratory Data ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Hypertensive Disorders Of Pregnancy ◽  
Ventricular Ejection Fraction ◽  
Hypertensive Disorders

Background: Cardiovascular functions and hemodynamics dramatically change during pregnancy such as cardiac output, expanded blood volume, reduced systematic vascular resistance, and heart chamber enlargement. Hypertensive disorders of pregnancy (HDP) may affect the cardiac load during pregnancy; however, the data about plasma concentration of cardiac troponin in pregnant women with HDP is very limited. Methods: We prospectively collected data of 751 pregnant women between 2012 and 2013 in Japanese general hospital. We analyzed laboratory data and echocardiographic findings after delivery. The elevated cTnI was defined as >0.015 ng/mL because the normal population have serum cTnI of less than 0.015 ng/mL in this assay. Results: The HDP were observed in 32 patients; the elevated cTnI was observed 40 patients. The age of patients with HDP (33.7 ±4.3 years) was not different from that of those without HDP (33.3 ± 5.0 years). The brain natriuretic peptides levels were not different between those with and without HDP. The proportion of elevated cTnI was higher in those with HDP (21.8%) than those without (3.6%, P<0.0001). After adjusting for confounders, the risk of elevated cTnI in those with HDP relative to those without HDP remained significant (odds ratio 4.52, 95% confidence interval 1.45-14.5). There were no women with reduced left ventricular ejection fraction. Conclusions: HDP was associated with elevated cTni, suggesting myocardial microinjury might occur more frequently in those with HDP.

scholarly journals Morphofunctional cardiac changes in pregnant women: associations with biomarkers

Open Heart ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. e000850 ◽  
Author(s):  
Takeshi Umazume ◽  
Takahiro Yamada ◽  
Satoshi Yamada ◽  
Satoshi Ishikawa ◽  
Itsuko Furuta ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Natriuretic Peptide ◽  
Troponin I ◽  
Vena Cava ◽  
Left Ventricular ◽  
Volume Index ◽  
Blood Levels ◽  
Lv Mass ◽  
Creatine Kinase Mb ◽  
In Pregnancy

ObjectiveThis longitudinal study was performed to determine changes in echocardiography parameters in association with various biomarker levels in pregnancy/postpartum.MethodsFifty-one healthy pregnant women underwent echocardiography with simultaneous determination of blood levels of five biomarkers at each of the first, second and third trimesters of pregnancy, immediately postpartum within 1 week after childbirth and approximately 1 month postpartum. Data on 255 echocardiography scans (five times per woman) and biomarkers were analysed.ResultsLeft ventricular end-diastolic dimension, left atrial (LA) volume index and left ventricular (LV) mass index increased with advancing gestation and reached the maximum immediately postpartum concomitant with the highest brain natriuretic peptide (BNP), N-terminal pro B-type natriuretic peptide (NT-proBNP), high-sensitivity troponin I (hs-TnI) and creatine kinase MB levels. The inferior vena cava diameter was significantly reduced in the third trimester compared with that in the first trimester and the peak occurred immediately after childbirth. In 255 paired measurements, hs-TnI level was significantly positively correlated with LA volume index and LV mass index; BNP and NT-proBNP were significantly positively correlated with LA volume index and estimated glomerular filtration rate (eGFR) was significantly positively correlated with the average of early diastolic septal and lateral mitral annular velocity (e′).ConclusionsMaximal cardiac changes in morphology occurred postpartum within 1 week after childbirth, not during pregnancy. BNP/NT-proBNP, hs-TnI and eGFR reflected cardiac changes in pregnancy.

Elevated level of N-terminal pro B-type natriuretic peptide is associated with myocardial fibrosis in hypertrophic cardiomyopathy patients with preserved ejection fraction

2020 ◽  
Author(s):  
Heshui Shi ◽  
Yumin Li ◽  
Jia Liu ◽  
Yukun Cao ◽  
Xiaoyue Zhou ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Ejection Fraction ◽  
Natriuretic Peptide ◽  
Myocardial Fibrosis ◽  
Troponin I ◽  
High Sensitivity ◽  
Left Ventricular ◽  
Preserved Ejection Fraction ◽  
Roc Curve Analysis ◽  
Potential Biomarker

Abstract Background: Myocardial fibrosis assessed by late gadolinium enhancement (LGE) on cardiovascular magnetic resonance (CMR) has been reported to be significantly correlated with cardiovascular outcomes in hypertrophic cardiomyopathy (HCM) patients. However, data regarding non-invasive markers for detecting myocardial fibrosis were inconsistent and, not systematically evaluated in HCM patients with preserved ejection fraction (EF).Methods: In this study, 86 HCM patients with preserved EF and 33 controls were enrolled. The left ventricular function, end-diastolic maximum wall thickness (MWT), global systolic strains and extent of LGE (% LGE) were assessed. The biochemical indices were also recorded before the CMR examination.Results: Serum high-sensitivity cardiac troponin I (hs-cTnI) and N-terminal pro b-type natriuretic peptide (Nt-proBNP) levels were elevated in LGE-positive patients compared with LGE-negative patients (p < 0.05 for all). The LGE-positive patients had lower global longitudinal (GLS) and circumferential (GCS) strains than the LGE-negative group and the healthy controls (p < 0.05 for all). The LGE% was independently associated with the Nt-proBNP levels (standardized β = 0.627, p < 0.001), beta-blocker treatment (standardized β = -0.372, p = 0.01), MWT (standardized β = 0.481, p = 0.001) and GCS (standardized β = 0.406, p = 0.013). In the receiver operating characteristic (ROC) curve analysis, the combined parameters of Nt-proBNP ≥ 108 pg/mL and MWT ≥ 17.3 mm had good diagnostic performance for LGE, with a specificity of 81.3% and sensitivity of 70.0%.Conclusions: This study suggests that Nt-proBNP may be a potential biomarker associated with LGE% and, combined with MWT, was useful in detecting myocardial fibrosis in HCM patients with preserved EF. Additionally, LV GCS may be a more sensitive indicator for reflecting the presence of myocardial fibrosis than GLS.

scholarly journals Association between thyroid-stimulating hormone and maternal hemodynamics in hypertensive disorders of pregnancy: an observational study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yu Liu ◽  
Bo Gao ◽  
Xin Zeng ◽  
Jing Yang ◽  
Lei Zhang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Birth Weight ◽  
Thyroid Stimulating Hormone ◽  
Hemodynamic Parameters ◽  
Hypertensive Disorders Of Pregnancy ◽  
Third Trimester ◽  
The Third ◽  
Hypertensive Disorders ◽  
Infant Birth ◽  
Tsh Levels

Abstract Background Hypertensive disorders of pregnancy (HDP) are characterized by hemodynamic disturbances. Altered thyroid function is a risk factor for poor outcomes of pregnancy. However, the associations between thyroid function biomarkers and maternal hemodynamics during pregnancy in HDP remain unclear. Methods From January 2016 to January 2018, pregnant women diagnosed with HDP admitted to the Nanjing Maternity and Child Health Care Hospital were prospectively enrolled in the third trimester. Normally distributed variables were expressed as mean ± standard deviation and skewed variables were expressed as median (25th percentile, 75th percentile). Correlations between thyroid-stimulating hormone (TSH) or free thyroxine (FT4) and maternal hemodynamic parameters were assessed by Pearson’s correlation coefficient and 95% confidence interval (95%CI). Bonferroni’s correction for multiple correlations was performed. Logistic regression models with odd ratio (OR) and 95%CI were applied to confirm the associations. Results A total of 163 third-trimester pregnant women with HDP with a mean gestational age of 35.62 ± 2.83 weeks were recruited. The infant birth weight of patients with elevated TSH levels was lower than that of patients with normal TSH levels (2635 ± 867 g vs. 3037 ± 673 g, p = 0.002). Reduced cardiac output (CO) was defined as CO < 3.5 L/min. The infant birth weight of patients with reduced CO was lower than that of patients with normal CO (2250 ± 510 g vs. 2890 ± 774 g, p = 0.002). TSH levels were significantly and negatively correlated with CO (r = − 0.260, 95%CI: − 0.392- -0.103, p < 0.001). FT4 levels were not significantly correlated with any of the maternal hemodynamic parameters (all p > 0.05). TSH level (OR = 1.371, 95%CI: 1.086–1.733, p = 0.008) was confirmed associated with reduced CO in the logistic regression analysis. Conclusions Elevated TSH levels are associated with reduced CO in HDP during the third trimester.

scholarly journals Left ventricular mass and myocardial scarring in women with hypertensive disorders of pregnancy

Open Heart ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. e001273
Author(s):  
Odayme Quesada ◽  
Ki Park ◽  
Janet Wei ◽  
Eileen Handberg ◽  
Chrisandra Shufelt ◽  
...  
Keyword(s):  
Vascular Dysfunction ◽  
Obstructive Coronary Artery Disease ◽  
Left Ventricular ◽  
Hypertensive Disorders Of Pregnancy ◽  
Similar Frequency ◽  
Hypertensive Disorders ◽  
Lv Mass ◽  
Scar Size ◽  
History Of ◽  
And Function

AimsHypertensive disorders of pregnancy (HDP) predict future cardiovascular events. We aim to investigate relations between HDP history and subsequent hypertension (HTN), myocardial structure and function, and late gadolinium enhancement (LGE) scar.Methods and resultsWe evaluated a prospective cohort of women with suspected ischaemia with no obstructive coronary artery disease (INOCA) who underwent stress/rest cardiac magnetic resonance imaging (cMRI) with LGE in the Women’s Ischemia Syndrome Evaluation-Coronary Vascular Dysfunction study. Self-reported history of pregnancy and HDP (gestational HTN, pre-eclampsia, toxaemia and eclampsia) were collected at enrollment. In our cohort of 346, 20% of women report a history of HDP. HDP history was associated with 3.2-fold increased odds of HTN. Women with a history of both HDP and HTN had higher cMRI measured left ventricular (LV) mass compared with women with HDP only (99.4±2.6 g vs 87.7±3.2 g, p=0.02). While we found a similar frequency of LGE scar, we observed a trend towards increased LGE scar size (5.1±3.4 g vs 8.0±3.4 g, p=0.09) among the women with HDP history compared to women without.ConclusionIn a high-risk cohort of women with suspected INOCA, 20% had a history of HDP. Women with HDP history were more likely to develop HTN. Our study demonstrates higher LV mass in women with HDP and concomitant HTN. Although the presence of LGE scar was not different in women with and without HDP history, we observed a trend towards larger scar size in women with HDP. Future studies are needed to better assess the relationship of HDP and cardiac morphology and LGE scarring in a larger cohort of women.

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