Document Detail


Left ventricular isovolumic relaxation and renin-angiotensin system in the growth restricted fetus.
MedLine Citation:
PMID:  18722896     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine left ventricular isovolumic relaxation time (LV IRT) in normally developing and growth restricted fetuses (FGR) as an indicator of fetal cardiac afterload and neonatal systolic blood pressure. STUDY DESIGN: A prospective longitudinal study in 124 normally developing and 47 growth restricted fetuses (FGR). LV IRT, fetal heart rate (FHR) and umbilical artery pulsatility index (PI) were determined at 2-3 week intervals starting at 22-26 weeks of gestation until delivery. Renin and angiotensin I levels were measured by radioimmunoassay in umbilical venous blood after delivery. Systolic blood pressure was measured at day 1 and day 5 of postnatal life. To evaluate the association between LV IRT, gestational age and FHR, bivariate regression analyses were performed. RESULTS: Mean LV IRT (62+/-8 ms) was 29 percent longer in FGR as compared to the normal subset (47+/-6 ms) at all gestational ages (p<0.001). Mean postnatal active plasma renin level (7.78+/-S.D. 1.03 ng/ml) and postnatal angiotensin I level (4.21+/-0.70 ng/ml) in the FGR subset were significantly higher (p<0.001) than in the normal subset (4.81+/-1.04 ng/ml, renin and 2.69+/-0.44 ng/ml, angiotensin I). There was a significant difference (p<0.01) in systolic blood pressure between the two subsets on postnatal day 1 (FGR 52+/-6 mmHg vs. normal 46+/-4 mmHg) and day 5 (FGR 76+/-5 mmHg vs. normal 60+/-6 mmHg). CONCLUSION: Left ventricular isovolumic relaxation time may act as a sensitive index of increased arterial afterload in the growth retarded fetus and may herald raised systolic blood pressure in the early neonatal period.
Authors:
Pavel B Tsyvian; Tatiana V Markova; Svetlana V Mikhailova; Wim C J Hop; Juriy W Wladimiroff
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of obstetrics, gynecology, and reproductive biology     Volume:  140     ISSN:  0301-2115     ISO Abbreviation:  Eur. J. Obstet. Gynecol. Reprod. Biol.     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-25     Completed Date:  2008-11-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375672     Medline TA:  Eur J Obstet Gynecol Reprod Biol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  33-7     Citation Subset:  IM    
Affiliation:
Mother and Child Care Institute, Yekaterinburg, Russia. p.tsyvian@iip.uran.ru
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MeSH Terms
Descriptor/Qualifier:
Adult
Angiotensins / blood*
Biological Markers
Case-Control Studies
Female
Fetal Blood / chemistry
Fetal Growth Retardation / physiopathology*
Heart Rate, Fetal
Humans
Hypertension / blood*
Infant, Newborn
Pregnancy
Prospective Studies
Renin / blood*
Renin-Angiotensin System / physiology
Ventricular Function, Left / physiology*
Chemical
Reg. No./Substance:
0/Angiotensins; 0/Biological Markers; EC 3.4.23.15/Renin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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