Amniotic Fluid Natriuretic Peptide Levels in Fetuses With Congenital Heart Defects or Arrhythmias

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  • Miyoshi Takekazu
    Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center Department of Obstetrics and Gynecology, Mie University
  • Hosoda Hiroshi
    Department of Regenerative Medicine and Tissue Engineering, National Cerebral and Cardiovascular Center
  • Umekawa Takashi
    Department of Obstetrics and Gynecology, Mie University
  • Asada Takashi
    Laboratory of Clinical Chemistry, National Cerebral and Cardiovascular Center
  • Fujiwara Akihiro
    Laboratory of Clinical Chemistry, National Cerebral and Cardiovascular Center
  • Kurosaki Ken-ichi
    Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center
  • Shiraishi Isao
    Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center
  • Nakai Michikazu
    Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center
  • Nishimura Kunihiro
    Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center
  • Miyazato Mikiya
    Department of Biochemistry, National Cerebral and Cardiovascular Center
  • Kangawa Kenji
    Department of Biochemistry, National Cerebral and Cardiovascular Center
  • Ikeda Tomoaki
    Department of Obstetrics and Gynecology, Mie University
  • Yoshimatsu Jun
    Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center
  • Minamino Naoto
    Omics Research Center, National Cerebral and Cardiovascular Center

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<p>Background: We have previously demonstrated that umbilical cord plasma natriuretic peptide (NP) levels reflect the severity of heart failure (HF) in fetuses with congenital heart defects (CHD). The aim of this study was to evaluate the significance of amniotic fluid (AF) NP levels in the assessment of HF in fetuses with CHD or arrhythmia. </p><p>Methods and Results: This was a prospective observational study at a tertiary pediatric cardiac center. A total of 95 singletons with CHD or arrhythmia, and 96 controls from 2012 to 2015 were analyzed. AF concentrations of atrial NP (ANP), B-type NP (BNP) and N-terminal pro-B-type NP (NT-proBNP) at birth were compared with ultrasonographic assessment of fetal HF using the cardiovascular profile (CVP) score. Multivariate analysis showed that a CVP score ≤5 and preterm birth are independently associated with high AF NT-proBNP levels. AF NT-proBNP levels of fetuses with CHD or arrhythmia inversely correlated with CVP score (P for trend <0.01). In contrast, AF concentrations of ANP and BNP were extremely low, and it was difficult to assess the degree of fetal HF based on them. </p><p>Conclusions: AF NT-proBNP concentrations increase in stepwise fashion with the severity of HF in fetuses with CHD or arrhythmia; it was the optimal NP for assessing the fetal HF. </p>

収録刊行物

  • Circulation Journal

    Circulation Journal 82 (10), 2619-2626, 2018-09-25

    一般社団法人 日本循環器学会

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