Document Detail


Cardiac troponin T as a biochemical marker of cardiac dysfunction and ductus venosus Doppler velocimetry.
MedLine Citation:
PMID:  19631447     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of this study was to determine the correlation between ductus venosus (DV) Doppler velocimetry and fetal cardiac troponin T (cTnT). STUDY DESIGN: Between March 2007 and March 2008, 89 high-risk pregnancies were prospectively studied. All patients delivered by cesarean section and the Doppler exams were performed on the same day. Multiple regression included the following variables: maternal age, parity, hypertension, diabetes, gestational age at delivery, umbilical artery (UA) S/D ratio, diagnosis of absent or reversed end-diastolic flow velocity (AREDV) in the UA, middle cerebral artery (MCA) pulsatility index (PI), and DV pulsatility index for veins (PIV). Immediately after delivery, UA blood samples were obtained for the measurement of pH and cTnT levels. Statistical analysis included the Kruskal-Wallis test and multiple regressions. RESULTS: The results showed a cTnT concentration at birth >0.05 ng/ml in nine (81.8%) of AREDV cases, a proportion significantly higher than that observed in normal UA S/D ratio and UA S/D ratio >p95 with positive diastolic blood flow (7.7 and 23.1%, respectively, p<0.001). A positive correlation was found between abnormal DV-PIV and elevated cTnT levels in the UA. Multiple regression identified DV-PIV and a diagnosis of AREDV as independent factors associated with abnormal fetal cTnT levels (p<0.0001, F(2.86)=63.5, R=0.7722). CONCLUSION: DV-PIV was significantly correlated with fetal cTnT concentrations at delivery. AREDV and abnormal DV flow represent severe cardiac compromise, with increased systemic venous pressure, and a rise in right ventricular afterload, demonstrated by myocardial damage and elevated fetal cTnT.
Authors:
Roseli Mieko Yamamoto Nomura; F??bio Roberto Cabar; Verb??nia Nunes Costa; Seizo Miyadahira; Marcelo Zugaib
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Publication Detail:
Type:  Journal Article     Date:  2009-07-23
Journal Detail:
Title:  European journal of obstetrics, gynecology, and reproductive biology     Volume:  147     ISSN:  1872-7654     ISO Abbreviation:  Eur. J. Obstet. Gynecol. Reprod. Biol.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-19     Completed Date:  2010-01-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375672     Medline TA:  Eur J Obstet Gynecol Reprod Biol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  33-6     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Faculty of Medicine, University of S??o Paulo, Brazil. roseli.nomura@terra.com.br
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MeSH Terms
Descriptor/Qualifier:
Adult
Biological Markers / blood
Blood Flow Velocity / physiology
Cross-Sectional Studies
Female
Fetus / blood supply*
Heart / physiopathology*
Humans
Infant, Newborn
Laser-Doppler Flowmetry
Middle Cerebral Artery / physiopathology
Placental Insufficiency / physiopathology
Pregnancy
Prospective Studies
Troponin T / blood*
Umbilical Arteries / physiopathology*
Umbilical Veins / physiopathology*
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Troponin T

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