Plasma natriuretic peptide levels reflect the status of the heart failure in fetuses with arrhythmia

Abstract

Objectives

To evaluate the significance of natriuretic peptide (NP) levels in fetal arrhythmia.

Study design

Cardiovascular profile (CVP) scores and umbilical vein (UV) NP levels at birth were compared by different fetal arrhythmia statuses.

Results

Fetal tachyarrhythmia (n = 22), bradyarrhythmia (n = 12), extrasystole (n = 12) and controls (n = 127) were enrolled in this study. Fetal antiarrhythmic therapy was performed in fetuses with tachyarrhythmia (n = 18) and bradyarrhythmia (n = 5). Fetal arrhythmias were divided into three groups: group A (arrhythmia controlled at birth, n = 17), Group B (arrhythmia uncontrolled at birth, n = 9) and Group C (fetal therapy not indicated, n = 20). Group B had significantly lower CVP scores and higher NP levels than the other two groups and controls (p < .01). Groups A and C had significantly lower CVP scores than controls, but NP levels in Groups A and C showed no differences compared with controls.

Conclusions

UV NP concentrations reflect the severity of fetal arrhythmia and responses to fetal therapy.

Keywords:

• Cardiovascular profile score
• congenital heart disease
• fetal arrhythmia
• fetal therapy
• heart failure
• natriuretic peptide

Acknowledgments

We thank the doctors in the Department of Perinatology and Gynecology for their assistance in collecting umbilical cord blood samples.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by JSPS KAKENHI grants [JP17K16316, 19K08343] from the Ministry of Education, Culture, Sports, Science and Technology of Japan; the Intramural Research Fund for Cardiovascular Disease [26-6-1, 27-1-5] from the National Cerebral and Cardiovascular Center of Japan; and the Tsuchiya Memorial Medical Foundation. These funding sources had no involvement in study design, in the collection, analysis and interpretation of data, in the writing of the report, and in the decision to submit the article for publication.