Increased fetal cardiac natriuretic peptide secretion in type‐1 diabetic pregnancies

Girsén, Anna; Ala-Kopsala, Minna; Mäkikallio, Kaarin; Vuolteenaho, Olli; Räsänen, Juha

doi:10.1080/00016340801899990

Cited by 16 publications

(22 citation statements)

References 42 publications

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“…To our knowledge the MPI index in macrosomic INDM infants have not been studied in the literature. We did not find a significant difference in pregestationalgestational IDMs and the control group according to the [9]. We were expecting higher MPI in study groups than the control group.…”

Section: Discussioncontrasting

confidence: 67%

“…A study on the infants of pregestational diabetic mothers showed that umbilical cord plasma proBNP levels were significantly higher than those of the control group [12,17]. Girsen et al [9] found higher umbilical artery plasma NT proBNP levels in infants of pregestational diabetic mothers with normal placental hemodynamics when compared to the control group.…”

Section: Discussionmentioning

confidence: 95%

“…The literature is mainly limited to infants of pregestational (type 1) diabetic mothers [9,12,17]. A study on the infants of pregestational diabetic mothers showed that umbilical cord plasma proBNP levels were significantly higher than those of the control group [12,17].…”

Section: Discussionmentioning

confidence: 97%

“…Therefore, studies use random or median HbA1c values of diabetic pregnant women in the study group [9,12,16]. Halse et al [12] divided pregestational IDMs into two groups: HbA1c level below 6.2 % and above 6.2 % (good and suboptimal metabolic control), and reported significantly high umbilical artery plasma proBNP levels in the suboptimal metabolic control group when compared to the control group.…”

Section: Discussionmentioning

confidence: 98%

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Troponin T and NT ProBNP Levels in Gestational, Type 1 and Type 2 Diabetic Mothers and Macrosomic Infants

et al. 2015

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This study compares NT proBNP and troponin T levels in umbilical cord arterial blood and postnatal echocardiographic findings for infants of gestational and pregestational diabetic mothers and macrosomic infants. Twenty-seven infants of pregestational diabetic mothers, 61 infants of gestational diabetic mothers and 37 macrosomic infants of nondiabetic mothers were prospectively enrolled in this study along with a control group of 58 healthy infants of mothers without any pregestational or gestational disorders as the control group. All enrollees were born after 34 weeks of gestation. For this study, umbilical cord blood was drawn during delivery to determine NT proBNP and troponin T levels. Echocardiography was performed 24-72 h after the delivery. Umbilical cord troponin T and NT proBNP levels were found to be higher in the diabetic and macrosomic groups than in the control group (all of them p < 0.001). NT proBNP levels were positively correlated with interventricular septum thickness in the pregestational and gestational infants of diabetic mothers groups (r = 0.564 and r = 0.560, respectively, p < 0.01). Both pregestational and gestational diabetic mothers were divided into two groups according to HbA1c levels in the third trimester as good (<6.1 %) and suboptimal (>6.1 %) metabolic control. In the good and suboptimal metabolic control diabetic groups, NT proBNP levels were also positively correlated with interventricular septum thickness (r = 0.536 and r = 0.576, respectively, p < 0.01). In the suboptimal metabolic control diabetic group, NT proBNP was only found to be positively correlated with the left ventricular mass index (r = 0.586, p < 0.01). While there was no correlation in the myocardial performance index between infants of diabetic mothers and the control group, the myocardial performance index of macrosomic infants was lower than that of the control group (p = 0.017). Cardiac biomarkers (NT proBNP and troponin T) were elevated in infants of diabetic mothers and macrosomic infants. While there was a positive correlation between NT proBNP levels and cardiac structure in infants of pregestational and gestational diabetic mothers, there was no relationship between NT proBNP levels and cardiac function.

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Section: Discussioncontrasting

confidence: 67%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 98%

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Troponin T and NT ProBNP Levels in Gestational, Type 1 and Type 2 Diabetic Mothers and Macrosomic Infants

et al. 2015

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“…The myocardial remodeling is associated with altered fetal cardiac diastolic function during the third trimester (48). In newborns of diabetic mothers, circulating atrial natriuretic peptide concentrations are elevated and correlate with maternal first-trimester glycosylated hemoglobin values even with good maternal glycemic control and normal placental hemodynamics (11). Animal studies yield conflicting results on fetal myocardial responses to maternal diabetes.…”

mentioning

confidence: 98%

Maternal hyperglycemia leads to fetal cardiac hyperplasia and dysfunction in a rat model

Lehtoranta

Vuolteenaho

Laine

et al. 2013

American Journal of Physiology-Endocrinology and Metabolism

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Accelerated fetal myocardial growth with altered cardiac function is a well-documented complication of human diabetic pregnancy, but its pathophysiology is still largely unknown. Our aim was to explore the mechanisms of fetal cardiac remodeling and cardiovascular hemodynamics in a rat model of maternal pregestational streptozotocin-induced hyperglycemia. The hyperglycemic group comprised 107 fetuses (10 dams) and the control group 219 fetuses (20 dams). Fetal cardiac function was assessed serially by Doppler ultrasonography. Fetal cardiac to thoracic area ratio, newborn heart weight, myocardial cell proliferative and apoptotic activities, and cardiac gene expression patterns were determined. Maternal hyperglycemia was associated with increased cardiac size, proliferative, apoptotic and mitotic activities, upregulation of genes encoding A- and B-type natriuretic peptides, myosin heavy chain types 2 and 3, uncoupling proteins 2 and 3, and the angiogenetic tumor necrosis factor receptor superfamily member 12A. The genes encoding Kv channel-interacting protein 2, a regulator of electrical cardiac phenotype, and the insulin-regulated glucose transporter 4 were downregulated. The heart rate was lower in fetuses of hyperglycemic dams. At 13-14 gestational days, 98% of fetuses of hyperglycemic dams had holosystolic atrioventricular valve regurgitation and decreased outflow mean velocity, indicating diminished cardiac output. Maternal hyperglycemia may lead to accelerated fetal myocardial growth by cardiomyocyte hyperplasia. In fetuses of hyperglycemic dams, expression of key genes that control and regulate cardiomyocyte electrophysiological properties, contractility, and metabolism are altered and may lead to major functional and clinical implications on the fetal heart.

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Impact of ineffective oesophageal motility and wrap type on dysphagia after laparoscopic fundoplication

Broeders

Sportel

Jamieson

et al. 2011

British Journal of Surgery

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Tailoring the degree of fundoplication according to preoperative oesophageal motility by standard manometric parameters has no long-term impact on postoperative dysphagia. There is, however, a proportionate increase in short-term dysphagia scores with increasing degree of wrap, and a corresponding proportionate increase in dilatations and reoperations for dysphagia. These differences in dysphagia scores diminish with time.

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Increased fetal cardiac natriuretic peptide secretion in type‐1 diabetic pregnancies

Cited by 16 publications

References 42 publications

Troponin T and NT ProBNP Levels in Gestational, Type 1 and Type 2 Diabetic Mothers and Macrosomic Infants

Troponin T and NT ProBNP Levels in Gestational, Type 1 and Type 2 Diabetic Mothers and Macrosomic Infants

Maternal hyperglycemia leads to fetal cardiac hyperplasia and dysfunction in a rat model

Impact of ineffective oesophageal motility and wrap type on dysphagia after laparoscopic fundoplication

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