Different expressions of cardiac biomarkers between different types of acquired right ventricular outflow tract abnormality in monochorionic twins
Different expressions of cardiac biomarkers between different types of acquired right ventricular outflow tract abnormality in monochorionic twins
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DOI：
10.1002/pd.6236
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发表时间：
2022-09-18
影响因子：
3
通讯作者：
Nakata，Masahiko
中科院分区：
文献类型：
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作者：
Takano，Mayumi;Hine，Kotaro;Nakata，Masahiko
目的探讨不同类型的右心室流出道（RVOT）异常单绒毛膜（MC）twins羊水心脏生物标志物和临床特征的差异。对双胎或较大双胎（A组）和供体或较小双胎（B组）进行评估，并将其分为右心室流出道正常（正常RVOT）、功能性肺动脉闭锁（fPA）或肺动脉狭窄（PS）。结果A组190例胎儿中，14例RVOT异常，其中7例fPA异常，7例PS异常。无B组胎仔显示RVOT异常结果。A组中，fPA组（25.1 ± 2.8周）和PS组（17.8 ± 0.9周）手术时孕龄较晚和较早。所有存活的PS病例均表现为进行性肺动脉瓣阻塞，而fPA组未观察到。fPA和PS组的AfNT‐proBNP显著高于正常RVOT组（p< 0.05）。结论A组RVOT异常类型间羊水心脏生物标志物表达不同，临床表现也不同。临床试验注册：本研究在日本临床试验注册中心“UMIN-CTR”注册（http：//www.umin.ac.jp/ctr/index-j.htm;试验ID编号UMIN 000024486和000037702）。
ObjectiveTo investigate the differences in amniotic fluid cardiac biomarkers and clinical features among types of right ventricular outflow tract (RVOT) abnormality in monochorionic (MC) twins.MethodThis prospective study included MC twins that underwent laser surgery. Recipient or larger twins (group A) and donor or smaller twins (group B) were assessed and divided into those with a normal right ventricular outflow tract (normal RVOT), functional pulmonary atresia (fPA), or pulmonary stenosis (PS). Amniotic fluid levels of NT‐proBNP (afNT‐proBNP) and cardiac troponin T (afTnT) were examined during surgery.ResultsOf 190 fetuses in group A, there were 14 RVOT abnormality cases (including 7 fPA and 7 PS). No group B fetuses showed RVOT abnormality findings. In group A, later and earlier gestational age at surgery were observed in fPA (25.1 ± 2.8 weeks) and PS groups (17.8 ± 0.9 weeks). All survived PS cases demonstrated progressive pulmonary valve obstruction, not observed in fPA groups. AfNT‐proBNP were significantly higher in fPA and PS than in the normal RVOT group (p< 0.05). AfTnT was significantly higher in group A with PS than fPA and normal RVOT groups (p< 0.05).ConclusionAmong RVOT abnormality types in group A, amniotic fluid cardiac biomarkers were differently expressed, and clinical features were also differentiated. These findings provide insight into the pathophysiological influence on RVOT in MC twins.Clinical trial registration:This study was registered with the Japanese Clinical Trial Registry “UMIN‐CTR” (http://www.umin.ac.jp/ctr/index‐j.htm; trial ID numbers UMIN000024486 and 000037702).