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Article: Fetal vascular programming: A twin study

TitleFetal vascular programming: A twin study
Authors
Issue Date2000
PublisherB M J Publishing Group. The Journal's web site is located at http://heart.bmjjournals.com/
Citation
Heart, 2000, v. 83 SUPPL. 1, p. P24 How to Cite?
AbstractBackground: Twin-twin transfusion syndrome (TTTS) occurring in monozygous twins is a useful model to investigate intrauterine programming independent of genetic influence. Both twins experience abnormal volume loading and increased placental resistance that may initiate vascular remodeling and permanently alter their physical properties. We examined whether twins surviving TTTS have altered arterial distensibility postnatally by comparing the pulse wave velocity (PWV ∝ 1/√distensibility) in the conduit arteries of twin pairs with and without TTTS and in a dichorionic control group. Methods Eighteen surviving twin pairs were studied; 6 pairs of monochorionic (MC) twins with TTTS, 7 pairs of MC twins without TTTS and 5 pairs of dichorionic twins. Fetal data on umbilical arterial pulsatility index, predictive factors for TTTS and duration of TTTS were collected prospectively. Brachio-radial arterial PWV was measured at a median corrected postnatal age of 9 (range 0.25 to 14) months using a photoplethysmographic technique and blood pressure measured. Results: MC twins with TTTS were more premature (p<0.01) and had the greatest co-twin birth weight difference. The mean PWV in donor twins was 98% higher (p=0.03) than that of their monozygous recipient co-twins. No co-twin difference in PWV was present in the other two groups, nor was any blood pressure difference identified in any of the three groups. Multiple regression analysis identified the donor status (β=2.50, p<0.01 ) and corrected postnatal age (β=0.32, p<0.01) as significant determinants of PWV. PWV discordance was significantly related to the duration of TTTS (r=0.94, p=0.005). Conclusions: Arterial distensibility in the brachio-radial artery was decreased in the donor twin in TTTS during infancy. These data suggest that vascular remodeling in utero, intended to be adaptive, may result in persistent functional vascular abnormalities that increase cardiac afterload and may prejudice later cardiovascular health.
Persistent Identifierhttp://hdl.handle.net/10722/170380
ISSN
2015 Impact Factor: 5.693
2015 SCImago Journal Rankings: 2.647

 

DC FieldValueLanguage
dc.contributor.authorCheung, YFen_US
dc.contributor.authorTaylor, Men_US
dc.contributor.authorFisk, NMen_US
dc.contributor.authorRedington, ANen_US
dc.contributor.authorGardiner, HMen_US
dc.date.accessioned2012-10-30T06:07:54Z-
dc.date.available2012-10-30T06:07:54Z-
dc.date.issued2000en_US
dc.identifier.citationHeart, 2000, v. 83 SUPPL. 1, p. P24en_US
dc.identifier.issn1355-6037en_US
dc.identifier.urihttp://hdl.handle.net/10722/170380-
dc.description.abstractBackground: Twin-twin transfusion syndrome (TTTS) occurring in monozygous twins is a useful model to investigate intrauterine programming independent of genetic influence. Both twins experience abnormal volume loading and increased placental resistance that may initiate vascular remodeling and permanently alter their physical properties. We examined whether twins surviving TTTS have altered arterial distensibility postnatally by comparing the pulse wave velocity (PWV ∝ 1/√distensibility) in the conduit arteries of twin pairs with and without TTTS and in a dichorionic control group. Methods Eighteen surviving twin pairs were studied; 6 pairs of monochorionic (MC) twins with TTTS, 7 pairs of MC twins without TTTS and 5 pairs of dichorionic twins. Fetal data on umbilical arterial pulsatility index, predictive factors for TTTS and duration of TTTS were collected prospectively. Brachio-radial arterial PWV was measured at a median corrected postnatal age of 9 (range 0.25 to 14) months using a photoplethysmographic technique and blood pressure measured. Results: MC twins with TTTS were more premature (p<0.01) and had the greatest co-twin birth weight difference. The mean PWV in donor twins was 98% higher (p=0.03) than that of their monozygous recipient co-twins. No co-twin difference in PWV was present in the other two groups, nor was any blood pressure difference identified in any of the three groups. Multiple regression analysis identified the donor status (β=2.50, p<0.01 ) and corrected postnatal age (β=0.32, p<0.01) as significant determinants of PWV. PWV discordance was significantly related to the duration of TTTS (r=0.94, p=0.005). Conclusions: Arterial distensibility in the brachio-radial artery was decreased in the donor twin in TTTS during infancy. These data suggest that vascular remodeling in utero, intended to be adaptive, may result in persistent functional vascular abnormalities that increase cardiac afterload and may prejudice later cardiovascular health.en_US
dc.languageengen_US
dc.publisherB M J Publishing Group. The Journal's web site is located at http://heart.bmjjournals.com/en_US
dc.relation.ispartofHearten_US
dc.titleFetal vascular programming: A twin studyen_US
dc.typeArticleen_US
dc.identifier.emailCheung, YF:xfcheung@hku.hken_US
dc.identifier.authorityCheung, YF=rp00382en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.scopuseid_2-s2.0-33750901457en_US
dc.identifier.volume83en_US
dc.identifier.issueSUPPL. 1en_US
dc.identifier.spageP24en_US
dc.publisher.placeUnited Kingdomen_US
dc.identifier.scopusauthoridCheung, YF=7202111067en_US
dc.identifier.scopusauthoridTaylor, M=7406242981en_US
dc.identifier.scopusauthoridFisk, NM=7102641855en_US
dc.identifier.scopusauthoridRedington, AN=7102622991en_US
dc.identifier.scopusauthoridGardiner, HM=7004840184en_US

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