Clinical meaning of serum trimethylamine oxide, N-terminal-pro-brain natriuretic peptide, hypoxia-inducible factor-1a and left ventricular function and pregnancy outcome in patients with pregnancy-induced hypertension.

Abstract

Background: To figure out the clinical meaning of serum trimethylamine oxide (TMAO), N-terminal-pro-brain natriuretic peptide (NT-proBNP) and hypoxia-inducible factor-1a (HIF-1a) with left ventricular function and pregnancy outcome in patients with pregnancy-induced hypertension.

Methods: From January 2018 to October 2020, 117 patients with gestational hypertension were taken as the research objects and grouped into the gestational hypertension (pregnancy-induced hypertension, 55 cases), mild preeclampsia (mild PE, 43 cases) and severe preeclampsia (severe PE, 19 cases) in the light of the severity of the disease. Analysis of the relation of serum TMAO, NT-proBNP and HIF-1a with the severity of disease and cardiac function indexes in patients with gestational hypertension was conducted. All patients were followed up to the end of pregnancy, and the predictive value of serum TMAO, NT-proBNP and HIF-1a on pregnancy outcome in patients was analyzed.

Results: Serum TMAO and NT-proBNP of patients were elevated, while HIF-1a was reduced with the severity of the disease (P < 0.05). Serum TMAO and NT-proBNP in patients with gestational hypertension were positively correlated but HIF-1a was negatively correlated with the severity of the disease (P < 0.05). Left ventricular end-diastolic volume (LVEDV) and left ventricular end-systolic volume (LVESV) were elevated in gestational hypertension patients, while ejection fraction (LVEF) was reduced with the severity of disease (P < 0.05). Serum TMAO, NT-proBNP and HIF1a were associated with LVEDV, LVESV and LVEF values in patients with gestational hypertension (P < 0.05). Serum TMAO and NT-proBNP were elevated but HIF-1a was reduced in patients with a poor pregnancy outcome (P < 0.05). The AUC of the combined detection of serum TMAO, NT-proBNP and HIF-1a on pregnancy outcome was greater (P < 0.05).

Conclusions: Serum TMAO, NT-proBNP and HIF-1a in patients with gestational hypertension are associated with disease severity and cardiac function, and have predictive and evaluative values for disease severity and pregnancy outcome.