Maternal cardiac function in early pregnancies with high uterine artery resistance.
OBJECTIVE
To compare the maternal cardiac function and serum concentration of cardiac troponin T (cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in first-trimester patients, according to uterine artery Doppler velocimetry (UADV).


METHODS
This cross-sectional study included singleton pregnancies with normal UADV (n=17) and abnormal UADV (n=19). Maternal echocardiography was performed and blood samples were taken at 11-14 weeks. Echocardiographic parameters included: (a) left ventricular (LV) long axis velocities; (b) atrial size; (c) LV filling pressure; (d) the ratio of peak mitral flow velocity in early diastole and early mitral annular diastolic velocity (E/Ea ratio); and (e) the E/flow propagation velocity ratio. The maternal serum concentrations of cTnT and NT-proBNP were determined by sensitive and specific immunoassays.


RESULTS
Patients with abnormal UADV had higher estimated left ventricular filling pressure (P=0.004), higher E/Ea ratio (P=0.03), higher E/flow propagation ratio (P=0.02), and lower LV long axis velocity (P=0.02) than those with normal UADV. There were no significant differences in the maternal serum concentration of cTnT or NT-proBNP.


CONCLUSIONS
Patients with abnormal UADV in the first trimester have higher left ventricular filling pressure and may have left ventricular systolic dysfunction.
Prefumo
F
F
Fetal Medicine Unit, Academic Department of Clinical Developmental Sciences, St George's, University of London, UK.
Sharma
R
R
Department of Cardiology, St. George's Hospital, London, UK.
Brecker
S J D
SJD
Department of Cardiology, St. George's Hospital, London, UK.
Gaze
D C
DC
Department of Chemical Pathology, St. George's Hospital, London, UK.
Collinson
P O
PO
Department of Chemical Pathology, St. George's Hospital, London, UK.
Thilaganathan
B
B
Fetal Medicine Unit, Academic Department of Clinical Developmental Sciences, St George's, University of London, UK.
D000328:Adult; D001158:Arteries / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D003326:Coronary Circulation / Q000502:physiology; D003430:Cross-Sectional Studies; D003971:Diastole; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging*; D011261:Pregnancy Trimester, First; D014599:Uterus / Q000098:blood supply* / Q000000981:diagnostic imaging; D014655:Vascular Resistance / Q000502:physiology*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*; D017725:Ventricular Pressure / Q000502:physiology
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain