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Licensed Unlicensed Requires Authentication Published by De Gruyter June 16, 2006

Cardiac troponin T and amino-terminal pro-natriuretic peptide concentrations in fetuses in the second trimester and in healthy neonates

  • Giuliana Fortunato , Patrizia Carandente Giarrusso , Pasquale Martinelli , Gabriella Sglavo , Michele Vassallo , Luigi Tomeo , Michelangelo Rea and Dario Paladini

Abstract

We measured the concentrations of cardiac troponin T (cTnT) and amino-terminal pro-natriuretic peptide (NT-proBNP) in umbilical cord blood during the second trimester (20–25weeks of gestation) and at delivery in 109 uncomplicated pregnancies to define reference values. Using the 97.5th percentile, the upper reference limits for cTnT and NT-proBNP were 0.308ng/mL and 5402pg/mL in fetuses in the second trimester, and 0.038ng/mL and 1690pg/mL in healthy neonates, respectively. We also evaluated whether labor and delivery mode affected the concentrations of the two analytes. We found significantly higher (p<0.001) umbilical blood NT-proBNP and cTnT levels at 20–25weeks of gestation than at term. In addition, within the term group, NT-proBNP concentrations were significantly higher in women delivering by elective cesarean section than in women delivering spontaneously (p<0.001), and higher than in women delivering by cesarean section during active labor. This indicates that the decrease in NT-proBNP levels is probably due to labor rather than delivery mode. Finally, we confirmed the at-birth reference values previously established for cTnT and NT-proBNP.

Clin Chem Lab Med 2006;44:834–6.


Corresponding author: Giuliana Fortunato, Dipartimento di Biochimica e Biotecnologie Mediche, Università di Napoli Federico II, via S. Pansini 5, 80131 Napoli, Italy Fax: +39-081-7462404,

References

1. de Lemos JA, Morrow DA. Combining natriuretic peptides and necrosis markers in the assessment of acute coronary syndromes. Rev Cardiovasc Med 2003; 4(Suppl 4):537–46.Search in Google Scholar

2. Walther T, Stepan H, Pankov K, Gembardt F, Faber R, Schultheiss HP, et al. Relation of ANP and BNP to their N-terminal fragments in fetal circulation: evidence for enhanced neutral endopeptidase activity and resistance of BNP to neutral endopeptidase in the fetus. Br J Obstet Gynaecol 2004; 111:452–5.10.1111/j.1471-0528.2004.00123.xSearch in Google Scholar PubMed

3. Bakker J, Gies I, Slavenburg B, Bekers O, Delhaas T, van Dieijen-Visser. References values for N-terminal pro-B-type natriuretic peptide in umbilical cord blood. Clin Chem 2004; 50:24–65.10.1373/clinchem.2004.040253Search in Google Scholar PubMed

4. Hammerer-Lercher A, Mair J, Tews G, Puschendorf B, Sommer R. N-Terminal pro-B-type natriuretic peptide concentrations are markedly higher in the umbilical cord blood of newborns than in their mothers. Clin Chem 2005; 51:913–5.10.1373/clinchem.2004.046557Search in Google Scholar PubMed

5. Fleming SM, O'Gorman T, O'Byrne L, Grimes H, Daly KM, Morrison JJ. Cardiac troponin I and N-terminal pro-brain natriuretic peptide in umbilical artery blood in relation to fetal heart rate abnormalities during labor. Pediatr Cardiol 2001; 22:393–6.10.1007/s002460010257Search in Google Scholar PubMed

6. Clark SJ, Newland P, Yoxall CW, Subhedar NV. Cardiac troponin T in cord blood. Arch Dis Child Fetal Neonatal Ed 2001; 84:F34–7.10.1136/fn.84.1.F34Search in Google Scholar PubMed PubMed Central

7. Baum H, Hinze A, Bartels P, Neumeier D. Reference values for cardiac troponins T and I in healthy neonates. Clin Biochem 2004; 37:1079–82.10.1016/j.clinbiochem.2004.08.003Search in Google Scholar PubMed

8. Walther T, Schultheiss HP, Tschope C, Stepan H. Natriuretic peptide system in fetal heart and circulation. J Hypertens 2002; 20:785–91.10.1097/00004872-200205000-00001Search in Google Scholar PubMed

9. Trevisanuto D, Pitton M, Altinier S, Zaninotto M, Plebani M, Zanardo V. Cardiac troponin I, cardiac troponin T and creatine kinase MB concentrations in umbilical cord blood of healthy term neonates. Acta Paediatr 2003; 92:1463–7.10.1111/j.1651-2227.2003.tb00832.xSearch in Google Scholar

10. Mar JH, Iannello RC, Ordahl CP. Cardiac troponin T gene expression in muscle. Symp Soc Exp Biol 1992; 46:237–49.Search in Google Scholar

11. Linask KK. Regulation of heart morphology: current molecular and cellular perspectives on the coordinated emergence of cardiac form and function, which eventually drive cells to organize into functioning organs. Birth Defects Research C 2003; 69:14–24.10.1002/bdrc.10004Search in Google Scholar PubMed

12. Walker JS, de Tombe PP. Titin and the developing heart. Circ Res 2004; 94:860–2.10.1161/01.RES.0000126698.37440.B0Search in Google Scholar PubMed

13. Anderson PA, Greig A, Mark TM, Malouf NN, Oakeley AE, Ungerleider RM, et al. Molecular basis of human cardiac troponin T isoforms expressed in the developing, adult, and failing heart. Circ Res 1995; 76:681–6.10.1161/01.RES.76.4.681Search in Google Scholar

14. Rychik J. Fetal cardiovascular physiology. Pediatr Cardiol 2004; 25:201–9.10.1007/s00246-003-0586-0Search in Google Scholar PubMed

15. Saba Z, Nassar R, Ungerleider R, Oakeley A, Anderson P. Cardiac troponin T isoform expression correlates with pathophysiological descriptors in patients who underwent corrective surgery for congenital heart disease. Circulation 1996; 94:472–6.10.1161/01.CIR.94.3.472Search in Google Scholar

16. Bajoria R, Ward S, Chatterjee R. Natriuretic peptides in the pathogenesis of cardiac dysfunction in the recipient fetus of twin-twin transfusion syndrome. Am J Obstet Gynecol 2002; 18:121–7.10.1067/mob.2002.118845Search in Google Scholar PubMed

17. Wlodek MF, Harding R, Thornburn GD. The influence of gestational age and onset of labour on determinants of fetal-maternal fluid and electrolyte balance in sheep. Dev Physiol 1992; 18:111–9.Search in Google Scholar

18. Fok WY, Yeung Leung T, Tsui MY, Leung TN, Lau TK. Fetal hemodynamic changes after amniotomy. Acta Obstet Gynecol Scand 2005; 84:166–9.10.1111/j.0001-6349.2005.00700.xSearch in Google Scholar PubMed

Received: 2006-1-26
Accepted: 2006-3-13
Published Online: 2006-6-16
Published in Print: 2006-7-1

©2006 by Walter de Gruyter Berlin New York

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