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Does endothelin-1 reduce superior mesenteric artery blood flow velocity in preterm neonates?
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  1. Fiona J Weira,
  2. Arne Ohlssona,d,
  3. Katherine Fongb,
  4. Kofi Amankwahc,
  5. Flavio Coceanie
  1. aDepartment of Newborn and Developmental Paediatrics, Women’s College Hospital, Toronto, Ontario, Canada, bDepartment of Medical Imaging, cDepartment of Obstetrics and Gynaecology, dMaternal, Infant and Reproductive Health Research Unit, eHospital for Sick Children, Integrative Biology Program
  1. Dr Arne Ohlsson Department of Paediatrics Mount Sinai Hospital 600 University Street, Toronto, Ontario, M5S 1B2. Email: aohlsson{at}mtsinai.on.ca

Abstract

AIM To compare plasma endothelin-1 (ET-1) concentrations in preterm neonates from pre-eclamptic and normal mothers; and to evaluate whether ET-1 has a role in altered arterial blood flow velocity.

METHODS Umbilical arterial blood and neonatal arterial blood were sampled on days 1 and 3 for gas analysis and measurement of plasma ET-1. Doppler ultrasonography of the middle cerebral, renal, and superior mesenteric arteries (SMA) was performed.

RESULTS Neonates in the pre-eclampsia (n=18) and control (n=18) groups had mean (SD) gestational ages of 31.1 (2.5) weeks and 30.4 (2.1) weeks; their birthweights were 1432 (SD 676) g and 1692 (SD 500) g, respectively. In the pre-eclampsia group mean umbilical arterial PO2 was lower—1.88 (0.75) kPa compared with 3.27 (1.41) kPa (p < 0.01)—and mean plasma ET-1 concentration was higher in the umbilical artery—40.6 (SD 15.0) compared with 30.5 (SD 13.8) pg/ml (p=0.04) and day 1 blood—54.9 (35.0) pg/ml compared with 33.6 (14.6) pg/ml (p=0.03). Middle cerebral artery peak systolic velocity was higher and SMA time averaged, peak systolic, and mean peak velocities were lower in the pre-eclampsia group. SMA time averaged velocity was inversely related to plasma ET-1 concentration.

CONCLUSION The association between increased production of ET-1 and reduction in SMA time averaged velocity suggests a possible mechanism for hypoperfusion of the intestinal wall in neonates.

  • eclampsia
  • hypoxia
  • vasoconstriction
  • endothelin-1
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