Fetal aortic stenosis and changes in amniotic fluid natriuretic peptides.
OBJECTIVE
Natriuretic peptides, especially brain natriuretic peptide (BNP), have demonstrated great usefulness in pediatric and adult cardiology. We studied their usefulness, based on amniotic fluid concentrations, in an ovine model of fetal aortic stenosis and in response to fetal cardiac intervention.


METHODS
After their natural history was established with gestation (n = 18 fetuses), natriuretic peptide levels were measured in a fetal model of aortic stenosis (50-60 days; term, 148 days; n = 9) and were correlated to the severity of fetal heart disease. Response to fetal cardiac intervention in 3 hydropic fetuses was also assessed. Significance was established with 2-sided paired t-tests at a probability value of <.05.


RESULTS
Amniotic fluid BNP (but not atrial natriuretic peptide) concentrations were elevated significantly with aortic stenosis (181.9 +/- 109.9 pg/mL vs 50.0 +/- 40.5 pg/mL in control fetuses), especially if complicated with hydrops (283 +/- 74.4 pg/mL), and were correlated positively with the severity of stenosis and left ventricle hypertrophy. In the 1 animal surviving fetal intervention, BNP levels normalized.


CONCLUSIONS
Amniotic fluid BNP concentrations correlate with the severity of fetal aortic stenosis.
Lubbers
Walter C
WC
Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH, USA.
Eghtesady
Pirooz
P
D000653:Amniotic Fluid / Q000737:chemistry*; D000818:Animals; D001024:Aortic Valve Stenosis / Q000175:diagnosis*; D005315:Fetal Diseases / Q000175:diagnosis*; D045265:Natriuretic Peptides / Q000032:analysis*; D012756:Sheep
D045265:Natriuretic Peptides