Troponin T and Pro–B-Type Natriuretic Peptide in Fetuses of Type 1 Diabetic Mothers

Russell, Nóirín; Higgins, Mary; Amaruso, Michael; Foley, Michael; McAuliffe, Fionnuala M.

doi:10.2337/dc09-0552

Cited by 38 publications

(40 citation statements)

References 28 publications

(39 reference statements)

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“…However, another study of the same group evaluated the correlation between umbilical artery troponin T and proBNP levels at the time of delivery and third trimester cardiac structure and function parameters of pregestational IDMs. The study found a correlation between proBNP level and IVS thickness; however, no such correlation was found with troponin T level [17]. Similarly, in our study, we found a positive correlation between the NT proBNP level and interventricular septum thickness in pregestational and gestational IDMs.…”

Section: Discussionsupporting

confidence: 60%

“…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: 96%

“…To our knowledge, the literature has only one study on troponin T levels in infants of diabetic mothers. Russel et al [17] found that the umbilical artery plasma troponin T value in infants of pregestational diabetic mothers was significantly higher than that in the control group. In our study, troponin T levels were found to be significantly higher in infants of pregestational and gestational diabetic mothers and macrosomic INDMs (p \ 0.001).…”

Section: Discussionmentioning

confidence: 96%

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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: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 96%

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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 together with the presence of positive correlation with the indicators of the cardiac diastolic and systolic dysfunction imply the value of cord blood cardiac troponin-T as an indicator of the cardiac injury associated with diabetes during pregnancy. Russell, et al [34] found higher concentration of cardiac troponin-T in the diabetic cohort than in the normal cohort and found higher concentration of cardiac troponin-T in infants of diabetic mothers, especially those with cardiomyopathy and those with poor perinatal outcome [34]. Tarkowska & Furmaga-Jabłońska [35] found significantly higher cardiac troponin-T levels in newborns with heart pathology than in healthy ones [35].…”

Section: /9mentioning

confidence: 99%

Correlation of Cord blood Cardiac Troponin-T to Echocardiographic and Tissue Doppler Variables in Infants of Diabetics Mothers with and without Hypertrophic Cardiomyopathy

Al‐Biltagi¹,

Serag²,

Al-Asy³

et al. 2016

JPNC

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Objective: The objective was to evaluate the value of cord blood cardiac troponin-T levels and tissue Doppler echocardiography in evaluation of hypertrophic cardiomyopathy in infants of diabetic mothers. Methods:A prospective study involved 60 infants of diabetic mothers and 60 healthy neonates.Cord blood level of cardiac troponin-T was measured and conventional and tissue Doppler echocardiographies were performed for all infants. Results:Hypertrophic cardiomyopathy was present in 19 cases (31.6%) of infants of diabetic mothers. There were significant increase in the cord blood cardiac troponin-T levels (P<0.0001) and more significant systolic and diastolic dysfunction in infants of diabetic mothers than in control group. Infants of diabetic mothers with hypertrophic cardiomyopathy had significant increase in the cord blood cardiac troponin-T levels (P<0.0001) and more significant systolic and diastolic dysfunction than infants of diabetic mothers without hypertrophic cardiomyopathy. There was no significant correlation between infant's birth weight and cord blood cardiac troponin-T levels while there was significant correlation between maternal glycosylated hemoglobin and cord blood levels of cardiac troponin-T. There were significant negative correlation between cord blood levels of cardiac troponin-T and E/A ratio at mitral valve, E'/A' ratio and S wave at mitral annulus, E/A ratio tricuspid valve, E'/A' ratio and S wave at tricuspid annulus. There were positive correlations between cord blood cardiac troponin-T levels with septal/posterior wall, and Tie indices.Conclusion: cardiac troponin-T was a useful marker especially when combined with tissue Doppler echocardiography for evaluation of hypertrophic cardiomyopathy in infants of diabetic mothers. Keywords:

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“…Classically, chronic hypoxia, hyperglycaemia and lactic acidosis are thought to contribute to the risk of intrauterine death but placental function may also play a part. Even well controlled pre-gestational diabetic mothers with normally grown fetuses have an increased risk of perinatal mortality and morbidity, including fetal cardiomyopathy and late third trimester unexplained fetal death [2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Clinical and ultrasound features of placental maturation in pre-gestational diabetic pregnancy

Higgins

Russell

Mooney

et al. 2012

Early Human Development

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Background: Pre-gestational diabetes (PGDM) is a significant cause of neonatal morbidity and mortality. Delayed villous maturation (DVM) is a placental diagnosis with increased risk of perinatal mortality. Aims: This study aimed to prospectively look at the incidence of DVM in a PGDM population compared to non-diabetic controls. Additionally, we analysed antenatal ultrasound and clinical markers for DVM in the diabetic population. Study design: This is a prospective study. Subjects: Placentae of women with non-diabetic and PGDM pregnancies underwent detailed blinded histopathological examination. Outcome measures: Clinical data, including birth weight, peri-natal outcome, and, in PGDM group, glycaemic control and ultrasound findings, were obtained. Results: 77 non-diabetic women and 74 PGDM women consented to the study. The incidence of DVM in the PGDM group was higher than in the non-diabetic group (21/74 (28.4%) vs. 11/77 (14.3%) p = 0.02; RR 1.98). In the PGDM group clinical and ultrasound markers were compared between the DVM group (n = 21) and the non-DVM group (n = 53). There was no difference in perinatal outcome nor glycaemic control between these two groups. Conclusion: DVM, a placental finding with an increased risk of perinatal mortality, is increased in PGDM population compared to non-diabetic controls. No association was found with maternal glycaemic control. The presence of placental DVM was not associated with antenatal ultrasound parameters nor clinical perinatal outcome.

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Troponin T and Pro–B-Type Natriuretic Peptide in Fetuses of Type 1 Diabetic Mothers

Cited by 38 publications

References 28 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

Correlation of Cord blood Cardiac Troponin-T to Echocardiographic and Tissue Doppler Variables in Infants of Diabetics Mothers with and without Hypertrophic Cardiomyopathy

Clinical and ultrasound features of placental maturation in pre-gestational diabetic pregnancy

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