Association of peripartum troponin i levels with left ventricular relaxation in women with hypertensive disorders of pregnancy

Takeshi Umazume, Satoshi Yamada, Takahiro Yamada, Satoshi Ishikawa, Itsuko Furuta, Hiroyuki Iwano, Daisuke Murai, Taichi Hayashi, Kazunori Okada, Mamoru Morikawa, Hiroyuki Tsutsui, Hisanori Minakami

研究成果: ジャーナルへの寄稿記事

抜粋

Objective Women with hypertensive disorders of pregnancy (HDP) show elevated risk of heart failure despite decreased circulating plasma volume compared with those with normotensive control pregnancies (NCP). This study was performed to better characterise the heart in women with HDP and determine whether high-sensitivity troponin I (hs-TnI) around childbirth predicts reduced left ventricular (LV) relaxation at 1 month postpartum. Methods Echocardiography was performed longitudinally during the first, second and third trimesters and immediately postpartum within 1 week and 1 month postpartum in 24 women with HDP, with simultaneous determination of blood variables in comparison with 51 women with NCP. Results Compared with NCP, HDP showed greater antepartum left atrial (LA) volume, LV mass and inferior vena cava (IVC) diameter, higher peripartum brain natriuretic peptide/N-terminal pro-B-type natriuretic peptide and hs-TnI with the highest value immediately postpartum, and lower early diastolic mitral annular velocity (e') during pregnancy/postpartum. In analyses of data on HDP and NCP, hs-TnI at the third trimester as well as that immediately postpartum was negatively correlated with later e' at 1 month postpartum. The areas under the receiver operating characteristic curves were 0.82 and 0.81 for hs-TnI at the third trimester and immediately postpartum, respectively, in the prediction of reduced LV relaxation at 1 month postpartum. Conclusion Reduced LV diastolic function and decreased splanchnic blood reservoir may contribute to the increased third trimester IVC diameter and LA volume in women with HDP. The rise in hs-TnI around childbirth was associated with poor LV relaxation ability at 1 month postpartum.

元の言語英語
記事番号e000829
ジャーナルOpen Heart
5
発行部数2
DOI
出版物ステータス出版済み - 2018

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    Umazume, T., Yamada, S., Yamada, T., Ishikawa, S., Furuta, I., Iwano, H., Murai, D., Hayashi, T., Okada, K., Morikawa, M., Tsutsui, H., & Minakami, H. (2018). Association of peripartum troponin i levels with left ventricular relaxation in women with hypertensive disorders of pregnancy. Open Heart, 5(2), [e000829]. https://doi.org/10.1136/openhrt-2018-000829