Does endothelin-1 reduce superior mesenteric artery blood flow velocity in preterm neonates?
a Department of
Newborn and Developmental Paediatrics, Women's
College Hospital, Toronto, Ontario, Canada, b Department of Medical Imaging, c Department
of Obstetrics and Gynaecology, d Maternal, Infant and Reproductive Health
Research Unit, e Hospital for
Sick Children, Integrative Biology Program
Correspondence to: Dr Arne Ohlsson Department of Paediatrics Mount Sinai Hospital 600 University Street, Toronto, Ontario, M5S 1B2. Email: aohlsson{at}mtsinai.on.ca
Accepted 16 October
1998
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.
METHODSUmbilical
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.
RESULTSNeonates 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
lower1.88 (0.75) kPa compared with 3.27 (1.41) kPa (p < 0.01)and
mean plasma ET-1 concentration was higher in the umbilical artery40.6
(SD 15.0) compared with 30.5 (SD 13.8) pg/ml (p=0.04) and day 1 blood54.9 (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.
CONCLUSIONThe
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.
© 1999 by Archives of Disease in Childhood
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