B-Type Natriuretic Peptide in Pregnant Women With Heart Disease
B-Type Natriuretic Peptide in Pregnant Women With Heart Disease
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DOI：
10.1016/j.jacc.2010.02.076
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发表时间：
2010-10-05
影响因子：
24
通讯作者：
Silversides, Candice K.
中科院分区：
文献类型：
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作者：
Tanous, David;Siu, Samuel C.;Silversides, Candice K.
目的本研究的目的是探讨：1)b型利钠肽（BNP）对心脏病妇女妊娠的反应；2) BNP水平与孕期孕产妇不良心脏事件的关系。背景：怀孕对心脏施加了血流动力学压力。BNP可能是评估心脏适应妊娠血流动力学负荷能力的有用生物标志物。方法：本研究是一项前瞻性研究，对象为在本中心就诊的结构性心脏病女性患者。在妊娠早期、妊娠晚期和分娩后（孕6周）获得一系列临床数据和血浆BNP测量。结果对78名孕妇进行了调查；66名患有心脏病的妇女（年龄31±5岁）和12名健康妇女（年龄33±5岁）。在怀孕期间，心脏病女性的BNP峰值中位数水平高于对照组（中位数为79，四分位数范围为51至152 pg/ml，中位数为35，四分位数范围为21至43 pg/ml， p < 0.001）。在患有心脏病的女性中，有主动脉下心室功能障碍的女性BNP水平较高（p = 0.03）。在所有怀孕期间发生事件的妇女（n = 8）中测量BNP >100 pg/ml。16名妇女在怀孕期间BNP水平升高，但没有临床事件。没有一个患有BNP的女人
Objectives The objectives of this study were to examine: 1) B-type natriuretic peptide (BNP) response to pregnancy in women with heart disease; and 2) the relationship between BNP levels and adverse maternal cardiac events during pregnancy.Background Pregnancy imposes a hemodynamic stress on the heart. BNP might be a useful biomarker to assess the ability of the heart to adapt to the hemodynamic load of pregnancy.Methods This was a prospective study of women with structural heart disease seen at our center. Serial clinical data and plasma BNP measurements were obtained during the first trimester, third trimester, and after delivery (>6 weeks).Results Seventy-eight pregnant women were studied; 66 women with heart disease (age 31 +/- 5 years), and 12 healthy women (age 33 +/- 5 years). During pregnancy, the median peak BNP level was higher in women with heart disease compared with control subjects (median 79, interquartile range 51 to 152 pg/ml vs. median 35, interquartile range 21 to 43 pg/ml, p < 0.001). In women with heart disease, those with subaortic ventricular dysfunction had higher BNP levels (p = 0.03). A BNP >100 pg/ml was measured in all women with events during pregnancy (n = 8). Sixteen women had increased BNP levels during pregnancy but did not have clinical events. None of the women with BNP