Association of amniotic fluid natriuretic peptide levels with ductus venosus Doppler flow in recipient twins with twin-to-twin transfusion syndrome
Association of amniotic fluid natriuretic peptide levels with ductus venosus Doppler flow in recipient twins with twin-to-twin transfusion syndrome
复制标题
患有双胎输血综合征的受者双胞胎中羊水钠尿肽水平与静脉导管多普勒血流的关系
DOI：
10.1007/s10396-022-01241-3
复制
发表时间：
2022
影响因子：
1.8
通讯作者：
Masahiko Nakata
中科院分区：
文献类型：
--
作者：
Mayumi Takano;Sumito Nagasaki;Junya Sakuma;Makiko Shimabukuro;Hikari Kotaki;Masahiko Nakata
PurposeThis study examined the relationships between fetal quantitative Doppler parameters and amniotic fluid N-terminal prohormone brain natriuretic peptide（afNT-proBNP）levels as a biomarkers of the increased cardiac load in recipient twins with twin-to-twin transfusion syndrome（TTTS）.MethodsThis single center，prospective study included all monochloronic diamniotic（MD）twin pregnancy that were diagnosed with TTTS and exceeded fetoscopic laser surgery.应用多普勒血流仪检测供、受者脐动脉、静脉导管和大脑中动脉搏动指数。在手术时检查受体双胞胎的afNT-proBNP水平。采用斯皮尔曼或皮尔逊相关系数评估afNT-proBNP水平与多普勒参数之间的关系。结果共纳入150例MD双胞胎妊娠。受体双生子afNT-proBNP水平与受体双生子DV-PI的相关性强于受体双生子UA-PI和MCA-PI（r= 0.637;P< 0.001）。结论TTTS患者双胞胎的DV-PI和afNT-proBNP水平呈正相关。DV-PI增加的受体双胞胎预期处于高心脏负荷下;因此，DV-PI是连续且非侵入性地评估增加的NT-proBNP水平的有用参数。临床试验注册该研究在日本临床试验注册处“UMIN-CTR”（http：//www.umin.ac.jp/ctr/index-j.htm;试验ID号UMIN 000024486和000037702）注册。
PurposeThis study examined the relationships between fetal quantitative Doppler parameters and amniotic fluid N-terminal prohormone brain natriuretic peptide (afNT-proBNP) levels as a biomarker of the increased cardiac load in recipient twins with twin-to-twin transfusion syndrome (TTTS).MethodsThis single-center, prospective study included all monochorionic diamniotic (MD) twin pregnancies that were diagnosed with TTTS and underwent fetoscopic laser surgery. Doppler flow was used to measure the pulsatility index (PI) of the umbilical artery (UA), ductus venosus (DV), and middle cerebral artery (MCA) of each recipient and donor twins. The afNT-proBNP levels of recipient twins were examined at the time of surgery. The Spearman or Pearson correlation coefficients were used to assess the relationships between afNT-proBNP levels and Doppler parameters.ResultsA total of 150 MD twin pregnancies were included. The afNT-proBNP levels of the recipient twins showed a stronger correlation with the DV-PI (r= 0.637;P< 0.001) of recipient twins than with the UA-PI and MCA-PI of recipient twins. The Doppler parameters of donor twins were scarcely correlated with the afNT-proBNP levels of the recipient twins.ConclusionA positive correlation between the DV-PI and afNT-proBNP levels of recipient twins with TTTS was observed. The recipient twin with an increased DV-PI is expected to be under a high cardiac load; therefore, DV-PI is a useful parameter for assessing increased NT-proBNP levels consecutively and noninvasively.Clinical Trial RegistrationThis study was registered with Japanese Clinical Trial Registry “UMIN-CTR” (http://www.umin.ac.jp/ctr/index-j.htm; trial ID numbers UMIN000024486 and 000037702).