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Pregnancy and cardiovascular disease

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https://www.readbyqxmd.com/read/28730459/fetal-programming-as-a-predictor-of-adult-health-or-disease-the-need-to-reevaluate-fetal-heart-function
#1
REVIEW
Joana O Miranda, Carla Ramalho, Tiago Henriques-Coelho, José Carlos Areias
Epidemiologic and experimental evidence suggests that adverse stimuli during critical periods in utero permanently alters organ structure and function and may have persistent consequences for the long-term health of the offspring. Fetal hypoxia, maternal malnutrition, or ventricular overloading are among the major adverse conditions that can compromise cardiovascular development in early life. With the heart as a central organ in fetal adaptive mechanisms, a deeper understanding of the fetal cardiovascular physiology and of the echocardiographic tools to assess both normal and stressed pregnancies would give precious information on fetal well-being and hopefully may help in early identification of special risk groups for cardiovascular diseases later in life...
July 20, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28728509/do-adverse-pregnancy-outcomes-contribute-to-accelerated-cardiovascular-events-seen-in-young-women-with-systemic-lupus-erythematosus
#2
M C Soh, C Nelson-Piercy, M Westgren, L McCowan, D Pasupathy
Cardiovascular events (CVEs) are prevalent in patients with systemic lupus erythematosus (SLE), and it is the young women who are disproportionately at risk. The risk factors for accelerated cardiovascular disease remain unclear, with multiple studies producing conflicting results. In this paper, we aim to address both traditional and SLE-specific risk factors postulated to drive the accelerated vascular disease in this cohort. We also discuss the more recent hypothesis that adverse pregnancy outcomes in the form of maternal-placental syndrome and resultant preterm delivery could potentially contribute to the CVEs seen in young women with SLE who have fewer traditional cardiovascular risk factors...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28722160/placental-proteomics-reveal-insights-into-fetal-alcohol-spectrum-disorders
#3
Katie L Davis-Anderson, Sebastian Berger, Emilie R Lunde-Young, Vishal D Naik, Heewon Seo, Greg A Johnson, Hanno Steen, Jayanth Ramadoss
Fetal alcohol spectrum disorders (FASD) describe many of the well-known neurodevelopmental deficits afflicting children exposed to alcohol in utero. The effects of alcohol on the maternal-fetal interface, especially the placenta, have been less explored. We herein hypothesized that chronic binge alcohol exposure during pregnancy significantly alters the placental protein profile in a rat FASD model METHODS: Pregnant rats were orogastrically treated daily with alcohol (4.5 g/kg, gestational day (GD) 5-10; 6...
July 19, 2017: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/28713290/advanced-maternal-age-worsens-postpartum-vascular-function
#4
Jude S Morton, Alison S Care, Raven Kirschenman, Christy-Lynn Cooke, Sandra T Davidge
The age at which women experience their first pregnancy has increased throughout the decades. Pregnancy has an important influence on maternal short- and long-term cardiovascular outcomes. Pregnancy at an advanced maternal age increases maternal risk of gestational diabetes, preeclampsia, placenta previa and caesarian delivery; complications which predict worsened cardiovascular health in later years. Aging also independently increases the risk of cardiovascular disease; therefore, combined risk in women of advanced maternal age may lead to detrimental cardiovascular outcomes later in life...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28711078/preeclampsia-pathogenesis-prevention-and-long-term-complications
#5
Belinda Jim, S Ananth Karumanchi
Preeclampsia continues to afflict 5% to 8% of all pregnancies throughout the world and is associated with significant morbidity and mortality to the mother and the fetus. Although the pathogenesis of the disorder has not yet been fully elucidated, current evidence suggests that imbalance in angiogenic factors is responsible for the clinical manifestations of the disorder, and may explain why certain populations are risk. In this review, we begin by demonstrating the roles that angiogenic factors play in pathogenesis of preeclampsia and its complications in the mother and the fetus...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28708846/sex-pregnancy-and-aortic-disease-in-marfan-syndrome
#6
Marjolijn Renard, Laura Muiño-Mosquera, Elise C Manalo, Sara Tufa, Eric J Carlson, Douglas R Keene, Julie De Backer, Lynn Y Sakai
BACKGROUND: Sex-related differences as well as the adverse effect of pregnancy on aortic disease outcome are well-established phenomena in humans with Marfan syndrome (MFS). The underlying mechanisms of these observations are largely unknown. OBJECTIVES: In an initial (pilot) step we aimed to confirm the differences between male and female MFS patients as well as between females with and without previous pregnancy. We then sought to evaluate whether these findings are recapitulated in a pre-clinical model and performed in-depth cardiovascular phenotyping of mutant male and both nulliparous and multiparous female Marfan mice...
2017: PloS One
https://www.readbyqxmd.com/read/28708773/angiotensin-ii-responsiveness-after-preeclampsia-translational-data-from-an-experimental-rat-model-and-early-onset-human-preeclampsia
#7
Anne M van der Graaf, Tsjitske J Toering, Mienke W K van der Wiel, Anne-Roos S Frenay, Gerd Wallukat, Ralf Dechend, Gerjan Navis, Henk Groen, A Titia Lely, Marijke M Faas
OBJECTIVE: Formerly preeclamptic women have an increased risk for cardiovascular and renal disease later in life. It is unknown which mechanisms contribute to this increased risk and whether this is induced by preeclampsia or by prepregnancy factors. We hypothesized that the increased risk for cardiovascular disease is partly due to an increased angiotensin II (ang II) responsiveness postpartum and that preeclampsia itself is involved in inducing this increased ang II responsiveness. METHODS: In never-pregnant, formerly healthy pregnant rats and rats with former experimental preeclampsia [experimental preeclampsia model induced by low-dose endotoxin infusion on day 14 of pregnancy; endotoxin-infused pregnant rats (EP-rats)], ang II responsiveness was studied by measuring changes in blood pressure (BP) and proteinuria after chronic ang II infusion with osmotic minipumps (200 ng/kg per min)...
July 13, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28705184/prevalence-of-gestational-diabetes-mellitus-based-on-various-screening-strategies-in-western-kenya-a-prospective-comparison-of-point-of-care-diagnostic-methods
#8
Sonak D Pastakia, Benson Njuguna, Beryl Ajwang' Onyango, Sierra Washington, Astrid Christoffersen-Deb, Wycliffe K Kosgei, Ponnusamy Saravanan
BACKGROUND: Early diagnosis of gestational diabetes mellitus (GDM) is crucial to prevent short term delivery risks and long term effects such as cardiovascular and metabolic diseases in the mother and infant. Diagnosing GDM in Sub-Saharan Africa (SSA) however, remains sub-optimal due to associated logistical and cost barriers for resource-constrained populations. A cost-effective strategy to screen for GDM in such settings are therefore urgently required. We conducted this study to determine the prevalence of gestational diabetes mellitus (GDM) and assess utility of various GDM point of care (POC) screening strategies in a resource-constrained setting...
July 14, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28701333/risk-of-post-pregnancy-hypertension-in-women-with-a-history-of-hypertensive-disorders-of-pregnancy-nationwide-cohort-study
#9
Ida Behrens, Saima Basit, Mads Melbye, Jacob A Lykke, Jan Wohlfahrt, Henning Bundgaard, Baskaran Thilaganathan, Heather A Boyd
Objectives To determine how soon after delivery the risk of post-pregnancy hypertension increases in women with hypertensive disorders of pregnancy and how the risk evolves over time.Design Nationwide register based cohort study.Setting Denmark.Populations 482 972 primiparous women with a first live birth or stillbirth between 1995 and 2012 (cumulative incidence analyses), and 1 025 118 women with at least one live birth or stillbirth between 1978 and 2012 (Cox regression analyses).Main outcome measures 10 year cumulative incidences of post-pregnancy hypertension requiring treatment with prescription drugs, and hazard ratios estimated using Cox regression...
July 12, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28696997/number-of-offspring-and-cardiovascular-disease-risk-in-men-and-women-the-role-of-shared-lifestyle-characteristics
#10
Maria C Magnus, Stamatina Iliodromiti, Debbie A Lawlor, Janet M Catov, Scott M Nelson, Abigail Fraser
BACKGROUND: Previous studies of the number of offspring and cardiovascular disease (CVD) report conflicting findings. We re-examined this association in both sexes to clarify the role of the cardiometabolic changes that women experience during pregnancy versus shared lifestyle characteristics. METHODS: We studied 180,626 women and 133,259 men participating in the UK Biobank cohort who were free of CVD at baseline. CVD events were obtained from hospital and death registers...
July 10, 2017: Epidemiology
https://www.readbyqxmd.com/read/28694860/postpartum-aortic-bifurcation-thrombosis-on-the-background-of-thrombophilic-disorder
#11
Roxana Elena Bohîltea, Natalia Turcan, Horia Muresian, Silvia Condu, Elvira Bratila, Monica Mihaela Cîrstoiu
Two main causes of arterial thrombosis are known: fi rst - atherosclerosis, extensively studied, and the second - atrial fi brillation. The lack of any risk factors and the occurrence at young age of a thrombotic event requires us to investigate possible other conditions, including inherited thrombophilia that is represented by a series of genetic disorders that increase the risk of thromboembolic disease. The role of thrombophilia in the occurrence of arterial thrombosis is inconsequential; this disorder is characterized by the tendency of developing venous thrombosis...
September 2016: Mædica
https://www.readbyqxmd.com/read/28694109/mathematical-modelling-of-the-maternal-cardiovascular-system-in-the-three-stages-of-pregnancy
#12
Chiara Corsini, Elena Cervi, Francesco Migliavacca, Silvia Schievano, Tain-Yen Hsia, Giancarlo Pennati
In this study, a mathematical model of the female circulation during pregnancy is presented in order to investigate the hemodynamic response to the cardiovascular changes associated with each trimester of pregnancy. First, a preliminary lumped parameter model of the circulation of a non-pregnant female was developed, including the heart, the systemic circulation with a specific block for the uterine district and the pulmonary circulation. The model was first tested at rest; then heart rate and vascular resistances were individually varied to verify the correct response to parameter alterations characterising pregnancy...
July 7, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28681178/heart-disease-and-pregnancy
#13
REVIEW
Reza Ashrafi, Stephanie L Curtis
Cardiac disease remains a major cause of morbidity and mortality in pregnant and post-partum women, although progress has been made, with specialist joint obstetric-cardiology clinics providing an integrated, safe and personalised service to these women. As a result, fewer non-specialist cardiologists are managing women in pregnancy with cardiovascular disease. The aim of this review is to provide a brief overview of current knowledge and practice in the field, with an emphasis on the major physiological changes which occur during pregnancy, focussing on progress through the trimesters, clinical assessment in pregnancy, management of delivery (concentrating on managed vaginal delivery), drug treatment, key conditions and risk assessment...
July 5, 2017: Cardiology and Therapy
https://www.readbyqxmd.com/read/28679072/long-term-associations-of-morbidity-with-air-pollution-a-catalogue-and-synthesis
#14
Frederick W Lipfert
I searched the NIH Medline database through January 2017 for long-term studies of morbidity and air pollution and cataloged them with respect to cardiovascular, respiratory, cancer, diabetes, hospitalization, neurological, and pregnancy-birth endpoints. The catalogue is presented as an online appendix. Associations with PM2.5, PM10, and NO2 were evaluated most frequently among the 417 ambient air quality studies identified. Associations with TSP, carbon, ozone, sulfur, vehicular traffic, radon, and indoor air quality were also reported...
July 5, 2017: Journal of the Air & Waste Management Association
https://www.readbyqxmd.com/read/28677927/-the-placenta-a-new-target-organ-for-hypertension
#15
Laure Lyne Burdet, Manuella Epiney, Aurélie Bornand, Antoinette Pechère-Bertschi, Agnès Ditisheim
The placenta has generated many beliefs over centuries and in all ethnicities. Considered in our society as a surgical waste, it is elsewhere contemplated for its mysterious protective powers, viewed as the seat of the soul, disposed of, burnt or even buried. However, once time is taken for its examination, the placenta tells a story. Of interest is the similarity observed between placental vascular disease in hypertensive pregnancy and atherosclerosis in coronary artery disease for example. Hypertension in pregnancy is frequent and associated with increased adverse obstetrical outcomes, and long-term risk of cardiovascular and kidney disease...
September 14, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28676635/syncytiotrophoblast-derived-extracellular-vesicles-transfer-functional-placental-mirnas-to-primary-human-endothelial-cells
#16
Tina Cronqvist, Dionne Tannetta, Matthias Mörgelin, Mattias Belting, Ian Sargent, Mary Familari, Stefan R Hansson
During the pregnancy associated syndrome preeclampsia (PE), there is increased release of placental syncytiotrophoblast extracellular vesicles (STBEVs) and free foetal haemoglobin (HbF) into the maternal circulation. In the present study we investigated the uptake of normal and PE STBEVs by primary human coronary artery endothelial cells (HCAEC) and the effects of free HbF on this uptake. Our results show internalization of STBEVs into primary HCAEC, and transfer of placenta specific miRNAs from STBEVs into the endoplasmic reticulum and mitochondria of these recipient cells...
July 4, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28675713/obesity-in-pregnancy-as-a-model-to-identify-women-at-risk-for-later-metabolic-syndrome
#17
C Neri, C Di Cesare, A Labianca, M Viggiano, A Caruso, G Paradisi
The aim of our study is to identify - in a cohort of obese women - cardiovascular and clinical risk factors in women with previous complicated pregnancies and protective factors in women with previous physiological pregnancies. A total of 135 nonpregnant obese women referring to Policlinico Gemelli in Rome were prospectively collected in 2009-2010. Thirty-two women matched inclusion criteria: 16 reported a previous physiological pregnancy and 16 reported previous obstetric complications. A clinical, instrumental and laboratory evaluation has been performed for each patient...
July 4, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/28652473/increased-angiotensin-ii-sensitivity-contributes-to-microvascular-dysfunction-in-women-who-have-had-preeclampsia
#18
Anna E Stanhewicz, Sandeep Jandu, Lakshmi Santhanam, Lacy M Alexander
Women who have had preeclampsia have increased cardiovascular disease risk; however, the mechanism(s) responsible for this association remain unclear. Microvascular damage sustained during a preeclamptic pregnancy may persist postpartum. The putative mechanisms mediating this dysfunction include a reduction in NO-dependent dilation and an increased sensitivity to angiotensin II. In this study, we evaluated endothelium-dependent dilation, angiotensin II sensitivity, and the therapeutic effect of angiotensin II receptor blockade (losartan) on endothelium-dependent dilation in vivo in the microvasculature of women with a history of preeclampsia (n=12) and control women who had a healthy pregnancy (n=12)...
August 2017: Hypertension
https://www.readbyqxmd.com/read/28652462/protective-low-frequency-variants-for-preeclampsia-in-the-fms-related-tyrosine-kinase-1-gene-in-the-finnish-population
#19
A Inkeri Lokki, Emma Daly, Michael Triebwasser, Mitja I Kurki, Elisha D O Roberson, Paavo Häppölä, Kirsi Auro, Markus Perola, Seppo Heinonen, Eero Kajantie, Juha Kere, Katja Kivinen, Anneli Pouta, Jane E Salmon, Seppo Meri, Mark Daly, John P Atkinson, Hannele Laivuori
Preeclampsia is a common pregnancy-specific vascular disorder characterized by new-onset hypertension and proteinuria during the second half of pregnancy. Predisposition to preeclampsia is in part heritable. It is associated with an increased risk of cardiovascular disease later in life. We have sequenced 124 candidate genes implicated in preeclampsia to pinpoint genetic variants contributing to predisposition to or protection from preeclampsia. First, targeted exomic sequencing was performed in 500 preeclamptic women and 190 controls from the FINNPEC cohort (Finnish Genetics of Preeclampsia Consortium)...
August 2017: Hypertension
https://www.readbyqxmd.com/read/28650953/de-novo-paternal-fbn1-mutation-detected-in-embryos-before-implantation
#20
Shuling Wang, Ziru Niu, Hui Wang, Minyue Ma, Wei Zhang, Shu Fang Wang, Jun Wang, Hong Yan, Yifan Liu, Na Duan, Xiandong Zhang, Yuanqing Yao
BACKGROUND Marfan syndrome (MFS) is an autosomal dominant disease caused by mutations in the Fibrillin (FBN)1 gene and characterized by disorders in the cardiovascular, skeletal, and visual systems. The diversity of mutations and phenotypic heterogeneity of MFS make prenatal molecular diagnoses difficult. In this study, we used pre-implantation genetic diagnosis (PGD) to identify the pathogenic mutation in a male patient with MFS and to determine whether his offspring would be free of the disease. MATERIAL AND METHODS The history and pedigree of the proband were analyzed...
June 26, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
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