Placental Expression of proBNP/NT-proBNP and Plasma Levels of NT-proBNP in Early- and Late-Onset Preeclampsia

Junus, Katja; Wikström, Anna‐Karin; Larsson, Anders; Olovsson, Matts

doi:10.1093/ajh/hpu033

Cited by 26 publications

(23 citation statements)

References 19 publications

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“…Alternatively, increased cardiac load and elevated serum levels of NT-proBNP/BNP may be two independent components of a relatively heterogeneous preeclampsia syndrome. Moreover, it should be remembered that a fraction of circulating NT-proBNP/BNP is released from the placenta [ 23 ].Our findings are consistent with the results of previous studies in which patients with PE and GH presented with significantly higher serum levels of NT-proBNP than women with uncomplicated pregnancies. Furthermore, we showed that elevated serum level of NT-proBNP is a significant indicatorof PE and GH.…”

Section: Discussionmentioning

confidence: 99%

Prenatal Clinical Assessment of NT-proBNP as a Diagnostic Tool for Preeclampsia, Gestational Hypertension and Gestational Diabetes Mellitus

2016

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Common complications of pregnancy include preeclampsia (PE), gestational hypertension (GH) and gestational diabetes mellitus (GDM). Hypertensive disorders (PE/GH) and GDM may result in greater maternal, fetal and neonatal morbidity and mortality. Women with PE/GH, one of the most common causes of heart burden in an obstetrical setting, present with elevated serum levels of BNP and NT-proBNP. The aim of this study was to shed more light on the role of NT-proBNP in pathophysiology of PE, GH and GDM. The study included 156 pregnant women with singleton pregnancies. A total of 26 women developed arterial hypertension during pregnancy, 14 were diagnosed with PE, and GDM was detected in 81 patients. The control group included 35 women with uncomplicated pregnancies, normal arterial blood pressure and normal glucose concentrations. Patients with GH presented with significantly higher serum concentrations of NT-proBNPthan normotensive women (65.5 vs. 37.4 pg/ml; p = 0.0136). Serum levels of NT-proBNP in patients with PE were the highest of all the analyzed subsets, being significantly higher than in women without this condition (89.00 vs. 37.4pg/ml,p = 0,0136). However, women with and without GDM did not differ significantly in terms of their serum NT-proBNPconcentrations. Serum NT-proBNP (pg/ml) (p = 0.0001) and BMI (p<0.0001) turned out to be independent predictors of GH on multivariate logistic regression analysis.Moreover, serum NT-proBNP (pg/ml) was identified as an independent indicator of PE (p = 0.0016). A significant inverse correlation was found between birth weight and maternal serum NT-proBNP concentrations. In our opinion, NT-proBNP can be a useful clinical marker of GH and PE. Determination of NT-proBNP levels may be helpful in identification of patients with PE and GH and in their qualification for intensive treatment; this in turn, may be reflected by better neonatal outcomes.

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Section: Discussionmentioning

confidence: 99%

Prenatal Clinical Assessment of NT-proBNP as a Diagnostic Tool for Preeclampsia, Gestational Hypertension and Gestational Diabetes Mellitus

2016

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“…So far, NT-proBNP, an unspecific marker for pregnancy complications such as preeclampsia as well as for heart failure and other diseases, is markedly elevated in most PPCM patients with little overlap to healthy peripartum women ( Table 1 ). 23 , 39 , 40 MiR-146a is specifically increased in the serum of PPCM patients compared with healthy postpartum women and patients with DCM ( Table 1 ). 23 , 38 sFlt1, a biomarker for preeclampsia that is supposed to clear rapidly after delivery, is significantly increased in PPCM patients as are asymmetric dimethyl arginine and Cathepsin D activity ( Table 1 ).…”

Section: Biomarkers For Diagnosis and Risk Stratification Of Peripartmentioning

confidence: 99%

Peripartum cardiomyopathy: current management and future perspectives

Hilfiker‐Kleiner

Haghikia

Nonhoff

et al. 2015

European Heart Journal

223

202

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Pregnancy is associated with marked physiological changes challenging the cardiovascular system. Among the more severe pregnancy associated cardiovascular complications, peripartum cardiomyopathy (PPCM) is a potentially life-threatening heart disease emerging towards the end of pregnancy or in the first postpartal months in previously healthy women. A major challenge is to distinguish the peripartum discomforts in healthy women (fatigue, shortness of breath, and oedema) from the pathological symptoms of PPCM. Moreover, pregnancy-related pathologies such as preeclampsia, myocarditis, or underlying genetic disease show overlapping symptoms with PPCM. Difficulties in diagnosis and the discrimination from other pathological conditions in pregnancy may explain why PPCM is still underestimated. Additionally, underlying pathophysiologies are poorly understood, biomarkers are scarce and treatment options in general limited. Experience in long-term prognosis and management including subsequent pregnancies is just beginning to emerge. This review focuses on novel aspects of physiological and pathophysiological changes of the maternal cardiovascular system by comparing normal conditions, hypertensive complications, genetic aspects, and infectious disease in PPCM-pregnancies. It also presents clinical and basic science data on the current state of knowledge on PPCM and brings them in context thereby highlighting promising new insights in diagnostic tools and therapeutic approaches and management.

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“…Three studies reporting on NTproBNP described elevated levels in pre-eclampsia vs. controls with P = 0.0103 ( Figure 6), [85][86][87] with insufficient studies for meta-analyses.…”

Section: Insulin Plasma Glucose and Fatty Acid-binding Proteinmentioning

confidence: 99%

Shared biomarkers between female diastolic heart failure and pre‐eclampsia: a systematic review and meta‐analysis

et al. 2017

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Evidence accumulates for associations between hypertensive pregnancy disorders and increased cardiovascular risk later. The main goal of this study was to explore shared biomarkers representing common pathogenic pathways between heart failure with preserved ejection fraction (HFpEF) and pre‐eclampsia where these biomarkers might be potentially eligible for cardiovascular risk stratification in women after hypertensive pregnancy disorders. We sought for blood markers in women with diastolic dysfunction in a first literature search, and through a second search, we investigated whether these same biochemical markers were present in pre‐eclampsia.This systematic review and meta‐analysis presents two subsequent systematic searches in PubMed and EMBASE. Search I yielded 3014 studies on biomarkers discriminating women with HFpEF from female controls, of which 13 studies on 11 biochemical markers were included. Cases had HFpEF, and controls had no heart failure. The second search was for studies discriminating women with pre‐eclampsia from women with non‐hypertensive pregnancies with at least one of the biomarkers found in Search I. Search II yielded 1869 studies, of which 51 studies on seven biomarkers were included in meta‐analyses and 79 studies on 12 biomarkers in systematic review.Eleven biological markers differentiated women with diastolic dysfunction from controls, of which the following 10 markers differentiated women with pre‐eclampsia from controls as well: C‐reactive protein, HDL, insulin, fatty acid‐binding protein 4, brain natriuretic peptide, N terminal pro brain natriuretic peptide, adrenomedullin, mid‐region pro adrenomedullin, cardiac troponin I, and cancer antigen 125.Our study supports the hypothesis that HFpEF in women shares a common pathogenic background with pre‐eclampsia. The biomarkers representing inflammatory state, disturbances in myocardial function/structure, and unfavourable lipid metabolism may possibly be eligible for future prognostic tools.

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Placental Expression of proBNP/NT-proBNP and Plasma Levels of NT-proBNP in Early- and Late-Onset Preeclampsia

Abstract: The results indicate possible placental production and release of proBNP/NT-proBNP into the maternal circulation.

Cited by 26 publications

References 19 publications

Prenatal Clinical Assessment of NT-proBNP as a Diagnostic Tool for Preeclampsia, Gestational Hypertension and Gestational Diabetes Mellitus

Prenatal Clinical Assessment of NT-proBNP as a Diagnostic Tool for Preeclampsia, Gestational Hypertension and Gestational Diabetes Mellitus

Peripartum cardiomyopathy: current management and future perspectives

Shared biomarkers between female diastolic heart failure and pre‐eclampsia: a systematic review and meta‐analysis

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