Cord blood cardiovascular biomarkers in tetralogy of fallot and D-transposition of great arteries
Por:
Gómez del Rincón O, Nogué L, Soveral I, Guirado L, Izquierdo N, Pérez-Cruz M, Masoller-Casas N, Escobar MC, Sanchez deToledo J, Martínez-Crespo JM, Mar Bennasar Sans and Crispi F
Publicada:
28 abr 2023
Ahead of Print:
28 abr 2023
Categoría:
Pediatrics, perinatology and child health
Resumen:
Previous reports suggest that cord blood biomarkers could serve as a prognostic tool for conotruncal congenital heart defects (CHD). We aimed to describe the cord blood profile of different cardiovascular biomarkers in a prospective series of fetuses with tetralogy of Fallot (ToF) and D-transposition of great arteries (D-TGA) and to explore their correlation with fetal echocardiography and perinatal outcome.MethodsA prospective cohort study (2014-2019), including fetuses with isolated ToF and D-TGA and healthy controls, was conducted at two tertiary referral centers for CHD in Barcelona. Obstetric ultrasound and fetal echocardiography were performed in the third trimester and cord blood was obtained at delivery. Cord blood concentrations of N-terminal precursor of B-type natriuretic peptide, Troponin I, transforming growth factor beta (TGF beta), placental growth factor, and soluble fms-like tyrosine kinase-1 were determined.ResultsThirty-four fetuses with conotruncal-CHD (22 ToF and 12 D-TGA) and 36 controls were included. ToF-fetuses showed markedly increased cord blood TGF beta (24.9 ng/ml (15.6-45.3) vs. normal heart 15.7 ng/ml (7.2-24.3) vs. D-TGA 12.6 ng/ml (8.7-37.9); P = 0.012). These results remained statistically significant even after adjusting for maternal body mass index, birth weight and mode of delivery. TGFss levels showed a negative correlation with the pulmonary valve diameter z-score at fetal echocardiography (r = -0.576, P = 0.039). No other differences were found in the rest of cord blood biomarkers among the study populations. Likewise, no other significant correlations were identified between cardiovascular biomarkers, fetal echocardiography and perinatal outcome.ConclusionsThis study newly describes increased cord blood TGF beta concentrations in ToF compared to D-TGA and normal fetuses. We also demonstrate that TGF beta levels correlate with the severity of right ventricle outflow obstruction. These novel findings open a window of research opportunities on new prognostic and potential preventive strategies.
Filiaciones:
Gómez del Rincón O:
BCNatal Fetal Medicine Research Center, Sant Joan de Déu Hospital, Barcelona, Spain
August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
Fetal Medicine Department, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
Nogué L:
BCNatal Fetal Medicine Research Center, Sant Joan de Déu Hospital, Barcelona, Spain
August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
Soveral I:
BCNatal Fetal Medicine Research Center, Sant Joan de Déu Hospital, Barcelona, Spain
Department of Obstetrics, Hospital General de Hospitalet, Barcelona, Spain
:
BCNatal Fetal Medicine Research Center, Sant Joan de Déu Hospital, Barcelona, Spain
Izquierdo N:
BCNatal Fetal Medicine Research Center, Sant Joan de Déu Hospital, Barcelona, Spain
Pérez-Cruz M:
BCNatal Fetal Medicine Research Center, Sant Joan de Déu Hospital, Barcelona, Spain
Sant Joan de Déu Research Institute (IRSJD), Barcelona, Spain
Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin Network, Carlos III Health Institute, Madrid, Spain
Masoller-Casas N:
BCNatal Fetal Medicine Research Center, Sant Joan de Déu Hospital, Barcelona, Spain
August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
Escobar MC:
Sant Joan de Déu Research Institute (IRSJD), Barcelona, Spain
Pediatric Cardiology Department, Sant Joan de Déu Hospital, Esplugues de Llobregat, Barcelona, Spain
Sanchez deToledo J:
Sant Joan de Déu Research Institute (IRSJD), Barcelona, Spain
Pediatric Cardiology Department, Sant Joan de Déu Hospital, Esplugues de Llobregat, Barcelona, Spain
Martínez-Crespo JM:
BCNatal Fetal Medicine Research Center, Sant Joan de Déu Hospital, Barcelona, Spain
August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
Fetal Medicine Department, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
Mar Bennasar Sans:
BCNatal Fetal Medicine Research Center, Sant Joan de Déu Hospital, Barcelona, Spain
August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
Crispi F:
BCNatal Fetal Medicine Research Center, Sant Joan de Déu Hospital, Barcelona, Spain
August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
Fetal Medicine Department, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
gold, Green Published
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