{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T21:52:17Z","timestamp":1791237137712,"version":"4.1.0"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Clinical utility of cardiac biomarker testing during pregnancy in women with preexisting cardiac disease is not well known. We studied the levels and temporal trends of NT-proBNP (N-terminal pro-B-type natriuretic peptide) and hs-cTnI (high-sensitivity cardiac troponin I) throughout pregnancy in women with preexisting cardiac disease and sought to assess the association between NT-proBNP and hs-cTnI and pregnancy outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Three hundred seven pregnant women with preexisting cardiac disease were prospectively recruited. Mixed-effects linear regression analysis was used to compare the NT-proBNP and hs-cTnI levels between time periods and subgroups. Logistic regression analysis adjusted for maternal age and CARPREG II (Cardiac Disease in Pregnancy) risk score assessed the association between NT-proBNP levels and adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Geometric mean NT-proBNP (95% CI) was stable through pregnancy with a transient significant increase with labor and delivery (101.4 pg\/mL [87.1\u2013118.1], 90.2 pg\/mL [78.5\u2013103.6], 153.6 pg\/mL [126.8\u2013186.1], and 112.2 pg\/mL [94.2\u2013133.7] for first\/second trimester, third trimester, labor\/delivery and postpartum, respectively). We observed a statistically significant difference in the NT-proBNP between women with preserved versus decreased systemic ventricular function, structurally normal versus abnormal heart, modified World Health Organization class 1, 2 versus modified World Health Organization class 3, 4 and no congenital heart disease versus congenital heart disease. Compared to those without events, median (interquartile range) NT-proBNP levels were significantly higher in those who had heart failure (204 pg\/mL [51\u2013450] versus 55 pg\/mL [31\u201397];\n                      <jats:italic>P<\/jats:italic>\n                      =0.001) and preeclampsia (98 pg\/mL [40\u2013319] versus 55 pg\/mL [31\u201399];\n                      <jats:italic>P<\/jats:italic>\n                      =0.027). NT-proBNP, adjusted for age and CARPREG II risk score, was significantly associated with combined heart failure and preeclampsia (adjusted odds ratio, 2.14 [95% CI, 1.48\u20133.10] per log NT-proBNP increase;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). NT-proBNP &lt;200 pg\/mL had a specificity of 91% and negative predictive value of 95% in predicting combined heart failure and preeclampsia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>NT-proBNP remains steady over the course of pregnancy with a transient increase during labor and delivery with higher levels in subgroups of stable cardiac patients. NT-proBNP level of 200 pg\/mL can be used in the diagnosis of heart failure\/preeclampsia in the pregnant cardiac population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circheartfailure.121.009018","type":"journal-article","created":{"date-parts":[[2022,8,16]],"date-time":"2022-08-16T14:00:52Z","timestamp":1660658452000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":29,"title":["Trending Cardiac Biomarkers During Pregnancy in Women With Cardiovascular Disease"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1528-2154","authenticated-orcid":true,"given":"Soohyun A.","family":"Chang","sequence":"first","affiliation":[{"name":"Division of Cardiology, St. Paul\u2019s Hospital (S.A.C., M.J., M.K., J.G.), University of British Columbia, Vancouver, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7710-2214","authenticated-orcid":true,"given":"Parm","family":"Khakh","sequence":"additional","affiliation":[{"name":"Faculty of Medicine (P.K.), University of British Columbia, Vancouver, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6713-5706","authenticated-orcid":true,"given":"Mikyla","family":"Janzen","sequence":"additional","affiliation":[{"name":"Division of Cardiology, St. Paul\u2019s Hospital (S.A.C., M.J., M.K., J.G.), University of British Columbia, Vancouver, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2582-2337","authenticated-orcid":true,"given":"Terry","family":"Lee","sequence":"additional","affiliation":[{"name":"Centre for Health Evaluation &amp; Outcome Sciences, Providence Health Care Research Institute (T.L.), University of British Columbia, Vancouver, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marla","family":"Kiess","sequence":"additional","affiliation":[{"name":"Division of Cardiology, St. Paul\u2019s Hospital (S.A.C., M.J., M.K., J.G.), University of British Columbia, Vancouver, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie","family":"Rychel","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, St. Paul\u2019s Hospital (V.R.), University of British Columbia, Vancouver, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7312-6278","authenticated-orcid":true,"given":"Jasmine","family":"Grewal","sequence":"additional","affiliation":[{"name":"Division of Cardiology, St. Paul\u2019s Hospital (S.A.C., M.J., M.K., J.G.), University of British Columbia, Vancouver, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0000000000000564"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.1989.256.4.H1060"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-196507000-00004"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/0033-0620(74)90028-0"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.4037\/aacnacc2018911"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejheart.2008.07.014"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000025242.79963.4c"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12779"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00391-8"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1494"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms20163874"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.peptides.2018.08.006"},{"key":"e_1_3_3_14_2","first-page":"15","article-title":"[Brain natriuretic peptide: physiological, biological and clinical aspects].","volume":"63","author":"Cauliez B","year":"2005","unstructured":"Cauliez, B, Berthe, MC, Lavoinne, A. 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