{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:08:31Z","timestamp":1792109311616,"version":"4.4.0"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,10,8]],"date-time":"2018-10-08T00:00:00Z","timestamp":1538956800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007449","name":"Takeda Science Foundation","doi-asserted-by":"publisher","award":["J042"],"award-info":[{"award-number":["J042"]}],"id":[{"id":"10.13039\/100007449","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Diagnosing fetal heart failure remains challenging because it is difficult to know how well the fetal myocardium will perform as loading conditions change. In adult cardiology, natriuretic peptides (NPs) are established markers of heart failure. However, the number of studies investigating NP levels in fetuses is quite limited. The aim of this study was to evaluate the significance of plasma NP levels in the assessment of heart failure in fetuses with a congenital heart defect (CHD) and\/or arrhythmia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a prospective observational study conducted at a tertiary pediatric cardiac center. A total of 129 singletons with CHD and\/or arrhythmia and 127 controls were analyzed between 2012 and 2015. Umbilical cord plasma atrial NP, brain NP and N\u2010terminal pro\u2010brain NP levels at birth were compared with ultrasonography findings indicating fetal heart failure, such as cardiovascular profile (CVP) score and morphological characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fetuses with CHD and\/or arrhythmia had higher NP levels than did controls (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.01). NP levels of fetuses with CHD and\/or arrhythmia were correlated inversely with CVP score (\n                      <jats:italic>P<\/jats:italic>\n                      for trend &lt;\u20090.01). No differences in NP levels were found in fetuses with CHD and\/or arrhythmia and a CVP score of \u2265\u20098 in comparison to controls. Multivariate analysis showed that a CVP score of \u2264\u20095, tachy\u2010 or bradyarrhythmia at birth, preterm birth and umbilical artery pH\u2009&lt;\u20097.15 were associated independently with high NP levels (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.01). Among fetuses with a CVP score of \u2264\u20097, abnormal venous Doppler sonography findings were significantly more common and more severe in fetuses with tachy\u2010 or bradyarrhythmia than in those with CHD, and those with tachy\u2010 or bradyarrhythmia had higher NP levels than did those with CHD (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.01). Fetuses with right\u2010heart defect and moderate or severe tricuspid valve regurgitation had significantly higher NP levels than did fetuses with other types of CHD (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Plasma NP levels in fetuses with CHD and\/or arrhythmia are correlated with the severity of fetal heart failure. Elevated NP levels are attributed mainly to an increase in central venous pressure secondary to arrhythmia or atrioventricular valve regurgitation due to CHD, rather than to the morphological abnormality itself. Copyright \u00a9 2017 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.18925","type":"journal-article","created":{"date-parts":[[2017,10,11]],"date-time":"2017-10-11T10:28:36Z","timestamp":1507717716000},"page":"609-616","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Plasma natriuretic peptide levels in fetuses with congenital heart defect and\/or arrhythmia"],"prefix":"10.1002","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0834-2411","authenticated-orcid":false,"given":"T.","family":"Miyoshi","sequence":"first","affiliation":[{"name":"Department of Perinatology and Gynecology National Cerebral and Cardiovascular Center  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Umekawa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Mie University  Tsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Hosoda","sequence":"additional","affiliation":[{"name":"Department of Regenerative Medicine and Tissue Engineering National Cerebral and Cardiovascular Center  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Asada","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Chemistry National Cerebral and Cardiovascular Center  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Fujiwara","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Chemistry National Cerebral and Cardiovascular Center  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. I.","family":"Kurosaki","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology National Cerebral and Cardiovascular Center  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Shiraishi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology National Cerebral and Cardiovascular Center  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Nakai","sequence":"additional","affiliation":[{"name":"Department of Statistics and Data Analysis Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Nishimura","sequence":"additional","affiliation":[{"name":"Department of Statistics and Data Analysis Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center  Suita 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