Detection of peripartum myocardial burden by vector-projected 187 channel electrocardiography and serum NT-proBNP
Autor: | Toru Sugiyama, Miyuki Terata, Akimune Fukushima, Kenji Nakai, Manabu Itoh, Akihiko Kikuchi |
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Rok vydání: | 2013 |
Předmět: |
Adult
medicine.medical_specialty Pregnancy Complications Cardiovascular Electrocardiography Young Adult Troponin T Pregnancy Internal medicine Heart rate Natriuretic Peptide Brain medicine Peripartum Period Repolarization Humans reproductive and urinary physiology medicine.diagnostic_test business.industry Myocardium General Medicine Myocardial Disorder medicine.disease Peptide Fragments Cardiology Gestation Female Cardiology and Cardiovascular Medicine business Cardiomyopathies Biomarkers |
Zdroj: | International heart journal. 54(3) |
ISSN: | 1349-3299 |
Popis: | There is no reliable method of screening for pregnant women at high risk of developing severe myocardial disorders. In this study, we used vector-projected 187 channel electrocardiography (DREAM-ECG) and serum biochemical markers to evaluate peripartum myocardial burden in pregnant women. Forty-one pregnant women were examined at 36-37 weeks gestation (GW36), 7 days postpartum (PPD7), and 1 month postpartum (PPM1). Ten non-pregnant control women were assessed at a single time point. Heart rate, sympathetic index, and repolarization index (RTc dispersion) were quantified using the DREAM-ECG system, and serum levels of NT-proBNP, cardiac troponin T, estrogen, and progesterone were determined. Heart rate and the sympathetic index decreased from GW36 to PPM1 (P = 0.0031). The repolarization index decreased over time and was greater than in non-pregnant controls (31 ± 13 ms). Estrogen and progesterone at PPD7 and PPM1 were significantly lower than those at GW36 (P < 0.0001, P < 0.001). NT-proBNP at PPD7 was greater than at GW36 (median 29 pg/mL at GW36, 86 pg/mL at PPD7), and decreased at PPM1 in comparison to PPD7 (median 18.5 pg/mL). Troponin T was in the normal range during the whole period (< 0.003 ng/mL). In conclusion, these results indicate that the peripartum myocardial burden in pregnant women does not return to normal nonpregnant levels by PPM1. We propose that both repolarization indexes such as RTc dispersion by DREAM-ECG and serum biochemical markers may identify pregnant women at high risk of developing severe myocardial damage in the peripartum period. |
Databáze: | OpenAIRE |
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