This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Model: BNP is a serum marker that reflects left ventricular function and is increased in people with heart failure. During pregnancy, the cardiac output increases and the plasma volume increases, therefore, the work of the heart increases. In reproductive age women where typically we do not see heart failure, there may be early signs of subclinical heart failure documented by elevations in BNP in vulnerable populations. Hypothesis: Native Hawaiians and Pacific Islanders will have higher BNP levels than others (Caucasian and Asian controls) in the third trimester.
Specific Aims : 1. Compare serum BNP levels in Native Hawaiian/part-Hawaiian and Pacific Islanders to serum BNP levels in Caucasians and Asians. 2. To collect specimens for a sample bank that will allow for future genetic analysis of variations in BNP expression. Study Design: 1. Cross-sectional study design measuring BNP in the third trimester at 32-36 weeks gestation. The subject will be recruited from the KMCWC Out-patient clinic, UCERA obstetric practice (on the 8th floor) and the private physicians offices at Kapiolani Medical Center for Women and Children. 2. Ancestry defined as identified ethnicity of four grandparents. 3. The following patient data will also be collected: gestational age, maternal age, height and weight and blood pressure. 4. Inclusion criteria are: Uncomplicated pregnancy between 32 and 36 weeks gestation, agreement to participate in study, and a knowledge of grandparents ethnicity 5. Exclusion criteria will include: Diabetes, known heart disease, hypertension, multi-fetal pregnancies, renal disease, and uncontrolled thyroid disease. 6. Sample Size: Equal numbers of ethnic groups will be recruited to total 200 patients. This will give 80% power to detect a 20% difference in BNP levels between ethnic groups. This sample size is calculated using a traditional 0.05 type I error rate for four (multiple) comparisons. The four ethnic groups will be: Native Hawaiian, Pacific Islander, Asian and Caucasian. Procedures: Subjects will be consented by Dr. Burlingame or her study staff. Then, an ethnicity questionnaire will be completed by the subject. Additional data collected includes gestational age, maternal age, weight, height, and blood pressure. 10 ml of blood will be collected. One tube of blood will be sent for BNP analysis. The other tube of blood will be stored at the University of Hawaii Medical school labs in the lab of Dr. Kenneth Ward.

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