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. 2017 Jul 26;45(5):577-583.
doi: 10.1515/jpm-2016-0266.

B-type natriuretic peptide and echocardiography reflect volume changes during pregnancy

Janet M Burlingame  1 , Kelly Yamasato  1 , Hyeong Jun Ahn  1 , Todd Seto  1 , W H Wilson Tang  1
Affiliations

B-type natriuretic peptide and echocardiography reflect volume changes during pregnancy

Janet M Burlingame et al. J Perinat Med. .

Abstract

Objective: To evaluate B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) and cardiac structure and function in normal women through pregnancy and the postpartum.

Methods: In this prospective observational study, we obtained serial transthoracic echocardiograms, BNP, and NT-proBNP at seven intervals from 6 weeks' gestation through 12 months postpartum. Women with hypertension or cardiac disease were excluded. Using 6-12 months postpartum as reference for non-pregnant levels, echocardiogram measurements and BNP/NT-proBNP were compared over time using linear mixed models with Tukey-Kramer adjustment for multiple comparisons.

Results: Of 116 patients, data was available for 78-114 healthy pregnant or postpartum women within each time interval, and 102 patients provided data for ≥4 intervals. Compared to 6-12 months postpartum, BNP and NT-proBNP remained stable through pregnancy and delivery, increased within 48 h postpartum (P<0.0001), then returned to baseline. Left ventricular volume increased within 48 h postpartum (P=0.021) while left atrial volume increased at 18-24 weeks (P=0.0002), 30-36 weeks (P<0.0001) and within 48 h postpartum (P=0.002). The transmitral early/late diastolic velocity (E/A) ratio, transmitral early/peak mitral annulus diastolic velocity (E/E') ratio, isovolumic relaxation times, and mitral valve deceleration times were similar within 48 h and 6-12 months postpartum.

Conclusion: In normal women, BNP/NT-proBNP, left atrial, and left ventricular volumes increase within 48 h postpartum without indications of altered diastolic function.

Keywords: Brain; echocardiography; natriuretic peptide, pregnancy; postpartum period.

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Conflict of interest statement

Conflict of interest: Authors state no conflict of interest.

Figures

Figure 1
Figure 1
Consort diagram.
Figure 2
Figure 2
B-type natriuretic peptide and N terminal-pro B-type natriuretic peptide through pregnancy and the postpartum period. P-value < 0.05 for a single time point compared to 6–12 months postpartum (non-pregnant). BNP=B-type natriuretic peptide; NT-proBNP=N terminal-pro B-type natriuretic peptide.
Figure 3
Figure 3
Left atrial and left ventricular volumes through pregnancy and the postpartum period. P-value < 0.05 for a single time point compared to 6–12 months postpartum (non-pregnant).
See this image and copyright information in PMC

References

    1. Kumari M, Tang WH, Maroo AP. Natriuretic peptide testing in high-risk pregnancy: A preventative opportunity? Curr Heart Fail Rep. 2014;11:471–6. - PubMed
    1. Tang WHW, Francis GS, Morrow DA, Newby K, Cannon CP, Jesse RL, et al. National academy of clinical biochemistry laboratory medicne practice guidelines: Clinical utilization of cardiac biomarker testing In heart failure. Circulation. 2007;116:99–109. - PubMed
    1. Clerico A, Passino C, Franzini M, Emdin M. Cardiac biomarker testing in the clinical laboratory: Where do we stand? General overview of the methodology with special emphasis on natriuretic peptides. Clin Chim Acta. 2015;443:17–24. - PubMed
    1. Suttner S, Boldt J. Natriuretic peptide system: physiology and clinical utility. Curr Opin Crit Care. 2004;10:336–41. - PubMed
    1. Tsai SH, Lin YY, Chu SJ, Hsu CW, Cheng SM. interpretation and use of natriuretic peptides in non-congestive heart failure settings. Yonsei Med J. 2010;51:151–63. - PMC - PubMed

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