Association between brain natriuretic peptide and cardiac dysfunction in hypertensive pregnancy disorders
Por:
Oliveros-Ruiz M.L., Vallejo, Maite, Lerma, Claudia, Murata, Chiharu, Navarro Robles, Jose, Lara J.G., De la Peña Díaz A.
Publicada:
1 ene 2022
Resumen:
Objective: The aim of this work is to identify the correlation between serum brain natriuretic peptide (BNP) and left ventricle (LV) systolic and diastolic function in hypertensive pregnancy disorders (HPD) through echocardiographic parameters. Study design: Eighty-seven pregnant patients were included, 23 with normotensive pregnancy (NP), 28 with gestational hypertension (GH) and 36 with preeclampsia (PE). Conventional 2D echocardiography was used to evaluate systolic and diastolic function such as E/a, E/e', LV mass index, LV ejection fraction, as well as left atria (LA) diameters, LA indexed volume, LV strain and LA strain (LAS). Brain natriuretic levels (BNP) blood levels were also determined. Main outcome measures: The serum levels of BNP were higher in patients with PE [median (interquartile range, IQR)] 189 (142–215) pg/ml and GH 105 (46–162) pg/ml compared to NP 23 (9–33) pg/ml, (p = 0.001). BNP levels had a negative correlation with LAS (Rho = -0.79, p < 0.001). Preeclampsia patients had lower LAS [median (IQR)] 22% (20%–24%) compared to the GH group 23% (20%–24%) and NP 35% (34% –35%), p = 0.001. Classification and Regression Trees multivariate analysis found patterns that define trends to form mutually excluding homogeneous groups such as: a) First parameter that separates 2 groups is septal e > 8.2 or < 8.2b), BNP serum levels above 89 pg/ml, and c) LAS increases the discriminatory performance to detect and define the diastolic dysfunction or not. Conclusions: At least one third of women with HPD had moderate diastolic dysfunction. The degree of diastolic dysfunction was negatively correlated with serum BNP levels and severity of HPD. LAS increase discriminatory performance to identify diastolic dysfunction in HPD. © 2022 International Society for the Study of Hypertension in Pregnancy
Filiaciones:
Echocardiography Laboratory Hospital de Especialidades de la Ciudad de México “Dr Belisario Domínguez”, Mexico City, 09790, Mexico
Hospital General “Enrique Cabrera”, Mexico City, CP 01618, Mexico
Programa de Doctorado en Ciencias Médicas, Odontológicas y de la Salud, Universidad Nacional Autonoma de Mexico, Mexico City, 04510, Mexico
Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, 14080, Mexico
Departamento de Metodología de la Investigación, Instituto Nacional de Pediatría, Mexico City, 04530, Mexico
Obstetrics Department Hospital de Especialidades de la Ciudad de Mexico “Dr Belisario Domínguez”, Mexico City, 09790, Mexico
Hosp Especialidades Ciudad Mexico Dr Belisario Do, Echocardiog Lab, Mexico City 09790, DF, Mexico
Hosp Gen Enrique Cabrera, Mexico City 01618, DF, Mexico
Univ Nacl Autonoma Mexico, Programa Doctorado Ciencias Med Odontol & Salud, Mexico City 04510, DF, Mexico
Inst Nacl Cardiol Ignacio Chavez, Mexico City 14080, DF, Mexico
Inst Nacl Pediat, Dept Metodol Invest, Mexico City 04530, DF, Mexico
Hosp Especialidades Ciudad Mexico Dr Belisario Do, Obstet Dept, Mexico City 09790, DF, Mexico
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