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Bastos JM, Scala N, Perpétuo L, Mele BH, Vitorino R. Integrative bioinformatic analysis of prognostic biomarkers in heart failure: Insights from clinical trials. Eur J Clin Invest 2025; 55:e70010. [PMID: 39957002 DOI: 10.1111/eci.70010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2024] [Accepted: 02/01/2025] [Indexed: 02/18/2025]
Abstract
BACKGROUND Heart failure (HF) remains a major cause of morbidity and mortality worldwide. Therefore, there is a need to identify robust biomarkers to improve early diagnosis, stratify disease severity and predict outcomes. Biomarkers such as galectin-3 (Gal-3), TIMP-1, BNP, NT-proBNP, CysC, CA125, ST2 and MMP9 have shown the potential to reflect the pathophysiology of HF. Despite their clinical potential, their integration into routine practice is still limited. The use of bioinformatics may help uncover critical associations between these biomarkers and the progression of HF, providing opportunities for personalized disease management. METHODS Following PRISMA guidelines, a systematic review of clinical studies was performed using databases with time constraints. The major proteins associated with HF were identified and their diagnostic and prognostic roles were analysed. RESULTS The study emphasizes that galectin-3 (Gal-3) and TIMP-1 serve as key indicators of fibrosis and inflammation, while BNP and NT-proBNP are reliable markers of cardiac stress. Cystatin C (CysC) reflects renal dysfunction, and CA125 correlates strongly with venous congestion. In addition, ST2 and MMP9 provide valuable insights into inflammation and tissue remodelling processes. These biomarkers are consistently elevated in patients with HF, emphasizing their critical role in detecting the systemic and cardiac manifestations of the disease. CONCLUSION Our results emphasize the importance of including biomarkers such as Gal-3, TIMP-1, BNP, NT-proBNP, CysC, CA125, ST2 and MMP9 in the diagnosis and treatment of HF. Their upregulation reflects the complex pathophysiological processes of HF and supports their use in the clinical setting to improve diagnostic accuracy, prognostic precision and personalized therapeutic strategies.
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Affiliation(s)
- José Mesquita Bastos
- Serviço de Cardiologia da Unidade de Saúde Local Região Aveiro, Aveiro, Portugal
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal
| | - Noemi Scala
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal
| | - Luís Perpétuo
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal
- Department of Surgery and Physiology, Faculty of Medicine, Cardiovascular R&D Centre-UnIC@RISE, University of Porto, Porto, Portugal
| | - Bruno Hay Mele
- Biology Department, University of Naples Federico II, Naples, Italy
| | - Rui Vitorino
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal
- Department of Surgery and Physiology, Faculty of Medicine, Cardiovascular R&D Centre-UnIC@RISE, University of Porto, Porto, Portugal
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Szczerba E, Kozyra-Pydyś E, Zajkowska A, Pankiewicz K, Szewczyk G, Maciejewski T, Małecki M, Fijałkowska A. Exploring the Role of miRNA-101a in the Circulatory System's Adaptive Mechanisms in Hypertensive Disorders of Pregnancy. Diagnostics (Basel) 2025; 15:535. [PMID: 40075783 PMCID: PMC11899601 DOI: 10.3390/diagnostics15050535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2025] [Revised: 02/17/2025] [Accepted: 02/19/2025] [Indexed: 03/14/2025] Open
Abstract
Background/Objectives: Hypertensive disorders of pregnancy constitute one of the principal reasons for maternal and perinatal morbidity and mortality worldwide. Identification of molecular mechanisms causing placental dysfunction resulting in gestational hypertension is crucial in the development of new methods of prevention and treatment. The aim of this case-control study was to assess changes in miRNA expression, and biomarkers such as NT-proBNP and galectin-3, in women with uncomplicated pregnancies and hypertensive disorders of pregnancy. Methods: This was a case-control study. We included 61 women with uncomplicated pregnancies and 31 women with hypertensive disorders of pregnancy (21 women with gestational hypertension and 10 women with chronic hypertension). Blood sample collection was performed at 33 weeks of gestation. Expression and expression levels of 26 microRNAs, NTproBNP, and galectin-3 were measured. Results: Lower expression of microRNA 101a was observed in patients with hypertensive disorders of pregnancy. The expression of microRNA 101a was significantly lower in the group of patients with gestational hypertension, but not with chronic hypertension. Not only was the expression of microRNA 101a lower in all women with gestational hypertension but also in XYZ% it reached undetectable levels. Other studied microRNAs were similar in expression and concentration levels among both groups. In all women with hypertensive disorders of pregnancy, statistically significant correlations were detected between NT-proBNP concentrations and microRNA 133a (r = -0.68; p = 0.030) and microRNA 195 (r = 0.67; p = 0.030), and between galectin-3 and microRNA 195 (r = 0.46; p = 0.010), microRNA 133a (r = 0.44; p = 0.020), microRNA 222-2276 (r = 0.39; p = 0.050). Conclusions: microRNA 101a, a molecule associated with placental dysfunction in preeclampsia and with inhibition of cardiac fibrosis, has lower expression and concentration levels in gestational hypertension but not in chronic hypertension.
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Affiliation(s)
- Ewa Szczerba
- Department of Cardiology, Institute of Mother and Child, 01-211 Warsaw, Poland; (E.S.); (A.F.)
- Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Eliza Kozyra-Pydyś
- Department of Cardiology, Institute of Mother and Child, 01-211 Warsaw, Poland; (E.S.); (A.F.)
| | - Agnieszka Zajkowska
- Department of Applied Pharmacy, Faculty of Pharmacy, Medical University of Warsaw, 02-097 Warsaw, Poland; (A.Z.); (M.M.)
| | - Katarzyna Pankiewicz
- Department of Obstetrics and Gynaecology, Institute of Mother and Child, 01-211 Warsaw, Poland; (K.P.); (T.M.)
| | - Grzegorz Szewczyk
- Department of Biophysics, Physiology and Pathophysiology, Medical University of Warsaw, 02-097 Warsaw, Poland;
- Department of Obstetrics, Gynecology and Gynecological Oncology, Mazovian Voivodship Hospital St John’s Paul 2nd Memorial, 08-110 Siedlce, Poland
| | - Tomasz Maciejewski
- Department of Obstetrics and Gynaecology, Institute of Mother and Child, 01-211 Warsaw, Poland; (K.P.); (T.M.)
| | - Maciej Małecki
- Department of Applied Pharmacy, Faculty of Pharmacy, Medical University of Warsaw, 02-097 Warsaw, Poland; (A.Z.); (M.M.)
- Laboratory of Gene Therapy, Faculty of Pharmacy, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Anna Fijałkowska
- Department of Cardiology, Institute of Mother and Child, 01-211 Warsaw, Poland; (E.S.); (A.F.)
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Nilsson EE, Winchester P, Proctor C, Beck D, Skinner MK. Epigenetic biomarker for preeclampsia-associated preterm birth and potential preventative medicine. ENVIRONMENTAL EPIGENETICS 2024; 10:dvae022. [PMID: 39606093 PMCID: PMC11602036 DOI: 10.1093/eep/dvae022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 10/23/2024] [Accepted: 11/04/2024] [Indexed: 11/29/2024]
Abstract
Preterm birth (PTB) has dramatically increased within the population (i.e. >10%) and preeclampsia is a significant sub-category of PTB. Currently, there are no practical clinical parameters or biomarkers which predict preeclampsia induced PTB. The current study investigates the potential use of epigenetic (DNA methylation) alterations as a maternal preeclampsia biomarker. Non-preeclampsia term births were compared to preeclampsia PTBs to identify DNA methylation differences (i.e. potential epigenetic biomarker). Maternal buccal cell cheek swabs were used as a marker cell for systemic epigenetic alterations in the individuals, which are primarily due to environmentally induced early life or previous generations impacts, and minimally impacted or associated with the disease etiology or gestation variables. A total of 389 differential DNA methylation regions (DMRs) were identified and associated with the presence of preeclampsia. The DMRs were genome-wide and were predominantly low CpG density (<2 CpG/100 bp). In comparison with a previous PTB buccal cell epigenetic biomarker there was a 15% (60 DMR) overlap, indicating that the majority of the DMRs are unique for preeclampsia. Few previously identified preeclampsia genes have been identified, however, the DMRs had gene associations in the P13 K-Akt signaling pathway and metabolic gene family, such as phospholipid signaling pathway. Preliminary validation of the DMR use as a potential maternal biomarker used a cross-validation analysis on the samples and provided 78% accuracy. Although prospective expanded clinical trials in first trimester pregnancies and clinical comparisons are required, the current study provides the potential proof of concept a preeclampsia epigenetic biomarker may exist. The availability of a preeclampsia PTB maternal susceptibility biomarker may facilitate clinical management and allow preventative medicine approaches to identify and treat the preeclampsia condition prior to its occurrence.
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Affiliation(s)
- Eric E Nilsson
- Center for Reproductive Biology, School of Biological Sciences, Washington State University, Pullman, WA 99164-4236, United States
| | - Paul Winchester
- Department of Pediatrics, St. Franciscan Hospital, School of Medicine, Indiana University, Indianapolis, IN 46202-5201, United States
| | - Cathy Proctor
- Department of Pediatrics, St. Franciscan Hospital, School of Medicine, Indiana University, Indianapolis, IN 46202-5201, United States
| | - Daniel Beck
- Center for Reproductive Biology, School of Biological Sciences, Washington State University, Pullman, WA 99164-4236, United States
| | - Michael K Skinner
- Center for Reproductive Biology, School of Biological Sciences, Washington State University, Pullman, WA 99164-4236, United States
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Wu H, Yu L, Xie Z, Cai H, Wen C. The impact of maternal serum biomarkers on maternal and neonatal outcomes in twin pregnancies: a retrospective cohort study conducted at a tertiary hospital. PeerJ 2024; 12:e18415. [PMID: 39484218 PMCID: PMC11526785 DOI: 10.7717/peerj.18415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 10/07/2024] [Indexed: 11/03/2024] Open
Abstract
Background Prior prediction models used for screening preeclampsia (PE) in twin pregnancies were found to be inadequate. In singleton pregnancies, various maternal biomarkers have been shown to be correlated with negative pregnancy outcomes. However, the impact of these biomarkers in twin pregnancies remained uncertain. Methods A retrospective cohort study was carried out on 736 twin pregnancies at a tertiary hospital in Hangzhou, China. Multivariable logistic models were employed to examine the association between levels of serological markers and the likelihood of adverse pregnancy outcomes. The final logistic model was formulated as a user-friendly nomogram. The primary outcome assessed was the occurrence of PE. Results were presented as odds ratios (ORs) with corresponding 95% confidence intervals (CIs). Results The prevalence of PE in the study was 10.3%. When comparing women diagnosed with PE to those without, it was evident that the former group experienced a significantly higher risk of unfavorable maternal and neonatal outcomes. A multivariable logistic regression analysis revealed notable associations between various factors including maternal age, parity, gestational weight gain, a family history of hypertension, as well as levels of cholesterol, albumin, and creatinine and the risk of developing PE, with a significance level of P < 0.05. The concordance index for the constructed nomogram was determined to be 0.792 (95% CI: [0.739-0.844]). Furthermore, an increment of 1 * 1012/L in red blood cell (RBC) count was associated with more than a two-fold increase in the odds of experiencing adverse maternal outcomes (OR 2.247, 95% CI: [1.229-4.107]). However, no significant correlations were identified between any of the examined variables and neonatal outcomes. Conclusions In this study, we developed a user-friendly predictive model that achieves notable detection rates by incorporating maternal serum biomarker levels alongside maternal characteristics and medical history. Our findings indicate that the probability of adverse maternal outcomes increases with elevated levels of RBCs. Obstetricians should consider intensifying surveillance for these women in clinical practice.
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Affiliation(s)
- Hanglin Wu
- Department of Obstetrics and Gynecology, Hangzhou Women’s Hospital, Hangzhou, Zhejiang, China
| | - Liming Yu
- Department of Obstetrics and Gynecology, Hangzhou Women’s Hospital, Hangzhou, Zhejiang, China
| | - Zhen Xie
- Department of Obstetrics and Gynecology, Hangzhou Women’s Hospital, Hangzhou, Zhejiang, China
| | - Hongxia Cai
- Department of Obstetrics and Gynecology, Hangzhou Women’s Hospital, Hangzhou, Zhejiang, China
| | - Caihe Wen
- Department of Obstetrics and Gynecology, Hangzhou Women’s Hospital, Hangzhou, Zhejiang, China
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Rosół N, Procyk G, Kacperczyk-Bartnik J, Grabowski M, Gąsecka A. N-terminal prohormone of brain natriuretic peptide in gestational hypertension and preeclampsia - State of the art. Eur J Obstet Gynecol Reprod Biol 2024; 297:96-105. [PMID: 38603986 DOI: 10.1016/j.ejogrb.2024.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 03/04/2024] [Accepted: 04/07/2024] [Indexed: 04/13/2024]
Abstract
N-terminal prohormone of brain natriuretic peptide (NT-proBNP) is a non-active prohormone secreted by ventricular cardiomyocytes into the circulation in response to ventricle overload, mainly due to increased blood volume. The changes in NT-proBNP levels during pregnancy have been investigated in multiple studies. In the case of hypertensive disorders of pregnancy, increased vasoconstriction leads to increased blood pressure and afterload. Together with the volume overload of pregnancy, it leads to higher NT-proBNP secretion. As hypertensive disorders of pregnancy are among the leading causes of prematurity and perinatal mortality, early prediction and diagnosis of gestational hypertension, and preeclampsia are essential for improving maternal and infant prognosis. NT-proBNP has been regarded as a potential biomarker of hypertensive disorders of pregnancy. In this review, we have thoroughly summarized the current data on the prognostic and diagnostic utility of NT-proBNP in patients with gestational hypertension and preeclampsia. NT-proBNP values may help distinguish between non-preeclamptic and preeclamptic patients, even if there are no significant differences in blood pressure. Moreover, in pregnancies complicated by preeclampsia, the value of increased NT-proBNP level is related to the stage and the severity of the disease. Further improvement of our knowledge about NT-proBNP as a diagnostic biomarker and a putative predictor of adverse cardiac events in women with hypertensive disorders of pregnancy should lead to better management of these patients.
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Affiliation(s)
- Natalia Rosół
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2, 00-315 Warsaw, Poland.
| | - Grzegorz Procyk
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Banacha 1A, 02-097 Warsaw, Poland.
| | - Joanna Kacperczyk-Bartnik
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2, 00-315 Warsaw, Poland.
| | - Marcin Grabowski
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Banacha 1A, 02-097 Warsaw, Poland.
| | - Aleksandra Gąsecka
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Banacha 1A, 02-097 Warsaw, Poland.
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Takahashi M, Suzuki L, Takahashi N, Hanaue M, Soda M, Miki T, Tateyama N, Ishihara S, Koshiishi T. Early-pregnancy N-terminal pro-brain natriuretic peptide level is inversely associated with hypertensive disorders of pregnancy diagnosed after 35 weeks of gestation. Sci Rep 2024; 14:12225. [PMID: 38806648 PMCID: PMC11133404 DOI: 10.1038/s41598-024-63206-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 05/27/2024] [Indexed: 05/30/2024] Open
Abstract
Hypertensive disorders of pregnancy (HDP) are among the major causes of high maternal and fetal/neonatal morbidity and mortality rates. Patients with HDP have significantly elevated N-terminal pro-brain natriuretic peptide (NT-proBNP) levels at diagnosis; however, the NT-proBNP levels during early pregnancy are largely unknown. This study aimed to validate the association between HDP and NT-proBNP levels. This retrospective study evaluated 103 pregnant women who developed HDP diagnosed after 35 weeks of gestation and 667 who did not. The HDP group had significantly lower early-pregnancy NT-proBNP levels than the without HDP group. However, the two groups did not significantly differ in terms of the late-pregnancy NT-proBNP levels. After adjusting for confounding factors such as age, body mass index, parity, and blood pressure levels, high early-pregnancy NT-proBNP levels were associated with a lower HDP risk. Early-pregnancy NT-proBNP levels ≥ 60.5 pg/mL had a negative predictive value of 97.0% for ruling out HDP, with a sensitivity of 87.4% and specificity of 62.5%. In conclusion, elevated early-pregnancy NT-proBNP levels were associated with a lower HDP risk. Moreover, a cutoff point of ≥ 60.5 pg/mL for early-pregnancy NT-proBNP levels had a high negative predictive value and sensitivity for ruling out HDP. These findings can provide new clinical implications.
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Affiliation(s)
| | - Luka Suzuki
- Department of Medicine, Diabetes Center, Quantitative Biosciences Institute (QBI), UCSF (University of California San Francisco), San Francisco, CA, USA
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | | | - Mayu Hanaue
- Hagukumi Maternal and Child Clinic, Kanagawa, Japan
| | | | - Tamito Miki
- Hagukumi Maternal and Child Clinic, Kanagawa, Japan
| | | | - Shiro Ishihara
- Department of Cardiology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
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Salamon D, Ujvari D, Hellberg A, Hirschberg AL. DHT and Insulin Upregulate Secretion of the Soluble Decoy Receptor of IL-33 From Decidualized Endometrial Stromal Cells. Endocrinology 2023; 165:bqad174. [PMID: 37972259 PMCID: PMC10681354 DOI: 10.1210/endocr/bqad174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 10/17/2023] [Accepted: 11/13/2023] [Indexed: 11/19/2023]
Abstract
Interleukin 33 (IL-33) signaling regulates most of the key processes of pregnancy, including decidualization, trophoblast proliferation and invasion, vascular remodeling, and placental growth. Accordingly, dysregulation of IL-33, its membrane-bound receptor (ST2L, transducer of IL-33 signaling), and its soluble decoy receptor (sST2, inhibitor of IL-33 signaling) has been linked to a wide range of adverse pregnancy outcomes that are common in women with obesity and polycystic ovary syndrome, that is, conditions associated with hyperandrogenism, insulin resistance, and compensatory hyperinsulinemia. To reveal if androgens and insulin might modulate uteroplacental IL-33 signaling, we investigated the effect of dihydrotestosterone (DHT) and/or insulin on the expression of ST2L and sST2 (along with the activity of their promoter regions), IL-33 and sIL1RAP (heterodimerization partner of sST2), during in vitro decidualization of endometrial stromal cells from 9 healthy women. DHT and insulin markedly upregulated sST2 secretion, in addition to the upregulation of its messenger RNA (mRNA) expression, while the proximal ST2 promoter, from which the sST2 transcript originates, was upregulated by insulin, and in a synergistic manner by DHT and insulin combination treatment. On the other hand, sIL1RAP was slightly downregulated by insulin and IL-33 mRNA expression was not affected by any of the hormones, while ST2L mRNA expression and transcription from its promoter region (distal ST2 promoter) could not be detected or showed a negligibly low level. We hypothesize that high levels of androgens and insulin might lead to subfertility and pregnancy complications, at least partially, through the sST2-dependent downregulation of uteroplacental IL-33 signaling.
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Affiliation(s)
- Daniel Salamon
- Department of Women's and Children's Health, Karolinska Institute, SE-171 64 Stockholm, Sweden
| | - Dorina Ujvari
- Department of Women's and Children's Health, Karolinska Institute, SE-171 64 Stockholm, Sweden
- Department of Microbiology, Tumor and Cell Biology, National Pandemic Centre, Centre for Translational Microbiome Research, Karolinska Institute, SE-171 64 Stockholm, Sweden
| | - Anton Hellberg
- Department of Women's and Children's Health, Karolinska Institute, SE-171 64 Stockholm, Sweden
| | - Angelica Lindén Hirschberg
- Department of Women's and Children's Health, Karolinska Institute, SE-171 64 Stockholm, Sweden
- Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, SE-171 76 Stockholm, Sweden
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Xiang Q, Wei Y, Feng X, Chen S, Zhao Y. Initial establishment and validation of a predictive model for preeclampsia in twin pregnancies based on maternal characteristics and echocardiographic parameters. Acta Obstet Gynecol Scand 2023; 102:1566-1574. [PMID: 37533238 PMCID: PMC10577616 DOI: 10.1111/aogs.14651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 06/22/2023] [Accepted: 07/12/2023] [Indexed: 08/04/2023]
Abstract
INTRODUCTION The primary objective of this study was to evaluate the association between maternal echocardiographic changes and the occurrence of preeclampsia (PE) in twin pregnancies. Additionally, we established and validated a prediction model for PE in twin pregnancies. MATERIAL AND METHODS The first part of this study was retrospective and included data from 854 twin pregnancies that received antenatal care at Peking University Third Hospital from April 2017 to April 2021 (training cohort). Overall, 159 women who underwent transthoracic echocardiography were included in the analysis. To build a predictive model, cardiac findings were compared between normotensive women and those with PE. The model was then validated in a prospective longitudinal cohort (test cohort) that included 109 women with twin pregnancies who underwent two consecutive transthoracic echocardiography examinations during the second and third trimesters. RESULTS Fifty-four normotensive women and 105 women with PE were analyzed in the retrospective cohort that was used to build the model in which later preeclampsia was associated with higher left ventricular mass index (>61 g/m2 ), interventricular septal thickness (>7.87 mm), left atrial anteroposterior diameter (>33.5 mm), mitral inflow late diastolic velocity (A) (>0.685 m/s), ratio of early diastolic velocity (E) and peak early diastolic myocardial velocity of the lateral mitral annulus (>6.5), and lower peak early diastolic myocardial velocity (<13.1 cm/s). The optimized PE prediction model based on the interventricular septal thickness, left atrial anteroposterior diameter, A, peak early diastolic myocardial velocity and pre-pregnancy bodyweight index was then established (area under the curve [AUC] = 0.840, 95% CI 0.778-0.903, P < 0.001). The model was tested in the prospective cohort including 87 normotensive women and 22 women with PE; the validation test showed that the prediction model in the second (AUC = 0.801) and third (AUC = 0.811) trimesters had high discriminative ability and calibration. CONCLUSIONS Maternal echocardiographic changes in twin pregnancies are associated with the development of preeclampsia. The model constructed, based on the echocardiographic parameters and body mass index, provides novel ideas for the prediction of PE.
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Affiliation(s)
- Qianqian Xiang
- Department of Obstetrics and GynecologyPeking University Third HospitalBeijingChina
- National Clinical Research Center of Obstetrics and GynecologyPeking University Third HospitalBeijingChina
- National Center for Healthcare Quality Management in ObstetricsBeijingChina
| | - Yuan Wei
- Department of Obstetrics and GynecologyPeking University Third HospitalBeijingChina
- National Clinical Research Center of Obstetrics and GynecologyPeking University Third HospitalBeijingChina
- National Center for Healthcare Quality Management in ObstetricsBeijingChina
| | - Xinheng Feng
- Department of CardiologyPeking University Third HospitalBeijingChina
| | - Shaomin Chen
- Department of CardiologyPeking University Third HospitalBeijingChina
| | - Yangyu Zhao
- Department of Obstetrics and GynecologyPeking University Third HospitalBeijingChina
- National Clinical Research Center of Obstetrics and GynecologyPeking University Third HospitalBeijingChina
- National Center for Healthcare Quality Management in ObstetricsBeijingChina
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