Cord Blood Cardiovascular Biomarkers in Left-Sided Congenital Heart Disease
Soveral, Iris (Hospital Clínic i Provincial de Barcelona)
Guirado, Laura (Hospital Clínic i Provincial de Barcelona)
Escobar-Diaz, Maria C. (Sant Joan de Déu Hospital)
Alcaide, María José (Hospital Universitario La Paz (Madrid))
Martínez, Josep Maria (Hospital Clínic i Provincial de Barcelona)
Rodríguez Sureda, Víctor (Hospital Clínic i Provincial de Barcelona)
Bijnens, Bart (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Antolin, Eugenia (Hospital Universitario La Paz (Madrid))
Llurba, E (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Bartha, José Luis (Hospital Universitario La Paz (Madrid))
Gómez, Olga (Hospital Clínic i Provincial de Barcelona)
Crispi, Fatima (Hospital Clínic i Provincial de Barcelona)
Universitat Autònoma de Barcelona

Data:	2022
Resum:	Fetal echocardiography has limited prognostic ability in the evaluation of left-sided congenital heart defects (left heart defects). Cord blood cardiovascular biomarkers could improve the prognostic evaluation of left heart defects. A multicenter prospective cohort (2013-2019) including fetuses with left heart defects (aortic coarctation, aortic stenosis, hypoplastic left heart, and multilevel obstruction (complex left heart defects) subdivided according to their outcome (favorable vs. poor), and control fetuses were evaluated in the third trimester of pregnancy at three referral centers in Spain. Poor outcome was defined as univentricular palliation, heart transplant, or death. Cord blood concentrations of N-terminal precursor of B-type natriuretic peptide, Troponin I, transforming growth factor β, placental growth factor, and soluble fms-like tyrosine kinase-1 were determined. A total of 45 fetuses with left heart defects (29 favorable and 16 poor outcomes) and 35 normal fetuses were included, with a median follow-up of 3. 1 years (interquartile range 1. 4-3. 9). Left heart defects with favorable outcome showed markedly increased cord blood transforming growth factor β (normal heart median 15. 5 ng/mL (6. 8-21. 4) vs. favorable outcome 51. 7 ng/mL (13. 8-73. 9) vs. poor outcome 25. 1 ng/mL (6. 9-39. 0), p = 0. 001) and decreased placental growth factor concentrations (normal heart 17. 9 pg/mL (13. 8-23. 9) vs. favorable outcome 12. 8 pg/mL (11. 7-13. 6) vs. poor outcome 11. 0 pg/mL (8. 8-15. 4), p < 0. 001). Poor outcome left heart defects had higher N-terminal precursor of B-type natriuretic peptide (normal heart 508. 0 pg/mL (287. 5-776. 3) vs. favorable outcome 617. 0 pg/mL (389. 8-1087. 8) vs. poor outcome 1450. 0 pg/mL (919. 0-1645. 0), p = 0. 001) and drastically reduced soluble fms-like tyrosine kinase-1 concentrations (normal heart 1929. 7 pg/mL (1364. 3-2715. 8) vs. favorable outcome (1848. 3 pg/mL (646. 9-2313. 6) vs. poor outcome 259. 0 pg/mL (182. 0-606. 0), p < 0. 001). Results showed that fetuses with left heart defects present a distinct cord blood biomarker profile according to their outcome.
Ajuts:	Ministerio de Economía y Competitividad PI15/00263 Ministerio de Economía y Competitividad RD16/0022/0015 Instituto de Salud Carlos III PI17/00675 Instituto de Salud Carlos III PI20/00246
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Angiogenic factors ; Aortic coarctation ; Aortic stenosis ; B-type natriuretic peptide ; Congenital heart defects ; Fetal cardiac remodeling ; Fetal echocardiography ; Hypoplastic left heart syndrome ; Transforming growth factor beta
Publicat a:	Journal of clinical medicine, Vol. 11 (november 2022) , ISSN 2077-0383

DOI: 10.3390/jcm11237119
PMID: 36498692

13 p, 1.1 MB

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