期刊
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
卷 199, 期 3, 页码 -出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.ajog.2008.06.056
关键词
cardiac function; Doppler ultrasound; heart fatty acid binding protein; intrauterine growth restriction; myocardial damage
资金
- MRC [G0700288, G0601295] Funding Source: UKRI
- Medical Research Council [G0700288, G0601295] Funding Source: researchfish
- British Heart Foundation [RG/09/001/25940] Funding Source: Medline
- Medical Research Council [G0601295, G0700288] Funding Source: Medline
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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