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Cardiomyopathy pregnancy

Wenmei Yang, Zhaoyi Lu, Zhifu Zhi, Liling Liu, Lingjie Deng, Xiaoli Jiang, Lihong Pang
Early Embryonic Arrest (EEA) is one of the major causes of female infertility. Genetic factors including specific genes and miRNAs may play pivotal roles on EEA. However, it is not well defined what genes and micro RNAs participate the pathophysiological alterations of EEA. In this work, we compared the Transcriptome -Seq and microRNA profiles from three pairs of villi (three EEA patients and three normal pregnancy, NP). We first confirmed the array data by qPCR with ten randomly selected differentially expressed genes and ten differentially expressed miRNAs in villi from 20 EEA and 20 NP controls...
February 15, 2019: Gene
Saereh Khanamiri, June-Wha Rhee, David T Paik, Ian Y Chen, Chun Liu, Nazish Sayed
Peripartum cardiomyopathy (PPCM) is a rare form of congestive heart failure characterized by left ventricular dysfunction that develops towards the end of pregnancy or during the early postpartum phase. Even though the majority of PPCM patients show partial or complete recovery of their heart functions, the mortality rate of PPCM remains high. Previous research has suggested that vascular dysfunction triggered by late-gestational hormones and potent anti-angiogenic factors play key roles in the pathogenesis of PPCM; however, the exact mechanisms remain elusive due to limited patient tissues for characterization...
February 14, 2019: Journal of Vascular Research
Christina M Ackerman, Marissa H Platner, Erica S Spatz, Jessica L Illuzzi, Xiao Xu, Katherine H Campbell, Graeme N Smith, Michael J Paidas, Heather S Lipkind
BACKGROUND: Cardiovascular disease (CVD) is the leading cause of pregnancy-related death in the United States. (1) Identification of short-term indicators of cardiovascular morbidity has the potential to alter the course of this devastating disease among women. It has been established that hypertensive disorders of pregnancy (HDP) are associated with increased risk of cardiovascular disease 10-30 years after delivery; however, little is known about the association of hypertensive disorders of pregnancy with cardiovascular (CV) morbidity during the delivery hospitalization...
February 8, 2019: American Journal of Obstetrics and Gynecology
Jenna Kaye Wildman, Bassam H Rimawi
Cerebrovascular disease is not uncommon during pregnancy as a result of either venous or arterial occlusion, or a hemorrhagic event, resulting in ischemia. Pregnancy may alter the prognosis of these neurologic disorders, with increased risks of morbidity and mortality for the mother and the developing fetus. Etiologies of stroke during pregnancy and the postpartum period include preeclampsia, eclampsia, HELLP syndrome, posterior reversible encephalopathy syndrome (PRES), amniotic fluid embolism, postpartum angiopathy, postpartum cardiomyopathy, thrombotic thrombocytopenic purpura (TTP), hemolytic uremic syndrome (HUS), cerebral venous thrombosis, CNS infections, and maternal thrombophilia...
January 2019: Case Reports in Women's Health
Nasim C Sobhani, Hayley Schultz, Ahmed Kheiwa, Molly Killion, Nisha I Parikh, Ian S Harris, Juan M Gonzalez, Anushree Agarwal
Maternal cardiac disease (MCD) is associated with increased maternal and neonatal morbidity and mortality. Because unplanned pregnancies are especially risky, active use of reliable contraception is critical in this population. Studies in the noncardiac population have demonstrated that the postpartum period is an ideal time to address contraceptive plans. This retrospective cohort study was designed to describe contraceptive choices in women with MCD in the immediate postpartum period and to identify factors associated with specific contraceptive plans...
January 25, 2019: American Journal of Cardiology
Michael C Honigberg, Michael M Givertz
Peripartum cardiomyopathy (PPCM) is a rare, often dilated, cardiomyopathy with systolic dysfunction that presents in late pregnancy or, more commonly, the early postpartum period. Although the condition is prevalent worldwide, women with black ancestry seem to be at greatest risk, and the condition has a particularly high incidence in Nigeria and Haiti. Other risk factors include pre-eclampsia, advanced maternal age, and multiple gestation pregnancy. Although the complete pathophysiology of peripartum cardiomyopathy remains unclear, research over the past decade suggests the importance of vasculo-hormonal pathways in women with underlying susceptibility...
January 30, 2019: BMJ: British Medical Journal
Omar Jiménez-Zarazúa, Lourdes N Vélez-Ramírez, José C Padilla-López, Juana R García-Ramírez, Pedro L González-Carillo, Jaime D Mondragón
Among the differential diagnoses that should be considered in acute respiratory failure (ARF) are infectious processes, autoimmune diseases, interstitial pulmonary fibrosis, and pulmonary neoplasia. Timely diagnosis of lung neoplasia is complicated in the early stages. An opportune diagnosis, as well as the specific treatment, decrease mortality. ARF occurs 1 in 500 pregnancies and is most common during the postpartum period. Among the specific etiologies that cause ARF during pregnancy that must be considered are: (1) preeclampsia; (2) embolism of amniotic fluid; (3) peripartum cardiomyopathy; and (4) trophoblastic embolism...
September 2018: Case Reports in Oncology
Cynthia S Shellhaas, Julie Zaharatos, Linda Clayton, Afshan Hameed
Deaths related to pregnancy were relatively common in the United States (U.S.) at the beginning of the twentieth century. A dramatic reduction of 99% in maternal mortality - from 850.0 to 7.5 per 100,000 live births between 1900 and 1982-is one of the most noteworthy public health success stories of the time period. This plateau continued until the late 1990s when maternal mortality began to rise again. The reasons for this increase are unclear. Vital statistics data alone cannot answer the many questions surrounding this increase...
January 22, 2019: American Journal of Obstetrics and Gynecology
Mechthild Westhoff-Bleck, Denise Hilfiker-Kleiner, Sabine Pankuweit, Bernhard Schieffer
Pregnancy-associated diseases of the cardiovascular system occur in up to 10% of all pregnancies and the incidence is increasing. Besides congenital heart disease or pre-existing cardiomyopathy in the mother, the clinical focus has moved especially to peripartum cardiomyopathy (PPCM) because of the condition's dramatic clinical course and the identification of the underlying mechanisms. This review article concentrates therefore on PPCM, which occurs either in the last month of pregnancy or in the first 6 months following delivery in women with previously healthy hearts...
December 2018: Geburtshilfe und Frauenheilkunde
Firdevs Aysenur Ekizler, Serkan Cay, Habibe Kafes, Ozcan Ozeke, Firat Ozcan, Serkan Topaloglu, Ahmet Temizhan, Dursun Aras
BACKGROUND: Peripartum cardiomyopathy (PPCM) is an uncommon complication of pregnancy. Clinical courses of PPCM are markedly heterogeneous. Positive T waves in lead aVR (TaVR) are shown to be associated with adverse cardiac events in several cardiovascular diseases. We aimed to investigate the prevalence and prognostic role of positive TaVR in patients with PPCM. METHODS: A total of 82 patients (mean age 29.1 ± 6.3 years) with the diagnosis of PPCM were enrolled...
January 17, 2019: Annals of Noninvasive Electrocardiology
Vânia Vieira Borba, Yehuda Shoenfeld
The sexual dimorphic prevalence of autoimmunity represents one of the most alluring observations among the mosaic of autoimmunity. Sex hormones are believed to be a mainstay of this asymmetry. The greater prevalence of autoimmunity among fertile women, disease onset/relapses during pregnancy, and postpartum are some of the points that support this theory. Undeniably, motherhood represents one of the most remarkable challenges for the immune system that not only has to allow for the conceptus but also deal with extraordinary hormonal alterations...
January 11, 2019: Clinical Rheumatology
Jacquelyn M Walejko, Andrew Antolic, Jeremy P Koelmel, Timothy J Garrett, Arthur S Edison, Maureen Keller-Wood
Our laboratory has previously shown in an ovine model of pregnancy that abnormal elevations in maternal cortisol during late gestation lead to increased fetal cardiac arrhythmias and mortality during peripartum. Furthermore, transcriptomic analysis of the fetal heart suggested alterations in TCA cycle intermediates and lipid metabolites in animals exposed to excess cortisol in utero. Therefore, we utilized a sheep model of pregnancy to determine how chronic increases in maternal cortisol alter maternal and fetal serum prior to birth and neonatal cardiac metabolites and lipids at term...
January 8, 2019: American Journal of Physiology. Endocrinology and Metabolism
Rachael C Baird, Shuo Li, Hao Wang, Sathyamangla V Naga Prasad, David Majdalany, Uma Perni, Qingyu Wu
BACKGROUND: Preeclampsia increases the risk of heart disease. Defects in the protease corin, including the variant T555I/Q568P found in approximately 12% of blacks, have been associated with preeclampsia and cardiac hypertrophy. The objective of this study was to investigate the role of corin and the T555I/Q568P variant in preeclampsia-associated cardiac alterations using genetically modified mouse models. METHODS: Virgin wild-type (WT) and corin knockout mice with or without a cardiac WT corin or T555I/Q568P variant transgene were mated at 3 or 6 months of age...
January 2019: Canadian Journal of Cardiology
F Gary Cunningham, John J Byrne, David B Nelson
Peripartum cardiomyopathy is defined by left ventricular dysfunction and development of cardiac failure without a known cause and occurring in the final month of pregnancy and up to 5 months postpartum. Peripartum cardiomyopathy is an important and steadily increasing cause of pregnancy-associated morbidity and mortality. The incidence of peripartum cardiomyopathy in the United States has been estimated recently as 1 in 2,230 births and approximately 1 in 1,000 births worldwide. The etiopathogenesis of peripartum cardiomyopathy remains elusive; however, it is generally thought to be from a two-hit hypothesis in which an underlying cardiomyocyte protein mutation results in apoptosis mediated by vascular and hormonal actions...
January 2019: Obstetrics and Gynecology
Mohamed Amine Bouslama, Fehmi Ferhi, Faten Hacheni, Kaabia Ons, Khlifi Abdeljelil, Khaled Ben Jazia, Hedi Khairi
We report the observation of a 25-year-old pregnant patient of 39 weeks of amenorrhea proposed for elective cesarean section. This patient suffers from hypertrophic cardiomyopathy since the age of 12. She has an implantable cardioverter defibrillator (ICD). The peculiarities of the ICD in the parturient and the perioperative management of the patient are being reported in this paper.
2018: Pan African Medical Journal
Julia M Lappin, Shane Darke, Johan Duflou, Sharlene Kaye, Michael Farrell
Background and Purpose- Fatal stroke during pregnancy and the puerperium is rare. Pregnancy-related hypertension and vascular abnormalities underlie significant proportions of pregnancy-related stroke, but up to one-quarter are of no known cause. Methods- Case series of fatal pregnancy-related stroke. All cases where the cause of death was attributed to stroke during pregnancy/postpartum were retrieved from the National Coronial Information System database (January 1, 2009 to December 31, 2016). Results- Fourteen fatal strokes were identified, all hemorrhagic in origin...
December 2018: Stroke; a Journal of Cerebral Circulation
Megan E Parrott, Esam Aljrbi, Diane L Biederman, Ryan N Montalvo, Jeremy L Barth, Holly A LaVoie
This study provides the first comprehensive analysis of extracellular matrix protein (ECM) gene expression combined with echocardiographic analyses of heart functional parameters in the murine heart during pregnancy and the early postpartum period. Our findings show regulation of all Timp, selected Mmps, and Col1a1, Col3a1, and Col8a1 mRNA levels with reproductive status, with the greatest number of significant changes occurring in the early postpartum period. Left ventricle cardiac diastolic parameters were the first to change during pregnancy and remained elevated postpartum, whereas systolic parameters were increased in late pregnancy and began to recover during the first week postpartum...
December 12, 2018: Experimental Biology and Medicine
J Hoevelmann, C A Viljoen, K Manning, J Baard, L Hahnle, M Ntsekhe, J Bauersachs, K Sliwa
BACKGROUND: Peripartum cardiomyopathy (PPCM) is an important cause of pregnancy-associated heart failure, which appears in previously healthy women towards the end of pregnancy or within five months following delivery. Although the ECG is widely used in clinical practice, its prognostic value has not been established in PPCM. METHODS: We analysed 12-lead ECGs of patients with PPCM, taken at index presentation and follow-up visits at 6 and 12 months. Poor outcome was determined by the composite endpoint of death, readmission, NYHA functional class III/IV or left ventricular ejection fraction (LVEF) of ≤35% at follow-up...
November 7, 2018: International Journal of Cardiology
Anna S Herrey, Jane M Francis, Marina Hughes, Ntobeko A B Ntusi
Aims: Cardiovascular disease is the leading cause of maternal morbidity and mortality, frequently requiring cardiac imaging for diagnosis, and follow-up. This need does not change pregnancy; however, many centres do not offer cardiovascular magnetic resonance (CMR) to pregnant patients. This paper explores current practice of CMR in pregnancy in four large volume centres, its safety and its impact on patient management. Methods and results: Between 2008 and 2017, we collected consecutive pregnant patients between four centres...
November 20, 2018: European Heart Journal Cardiovascular Imaging
U Seeland, J Bauersachs, J Roos-Hesselink, V Regitz-Zagrosek
Heart diseases are the most common cause of maternal death during pregnancy in Western countries. The current ESC guidelines 2018 for the management of cardiovascular diseases during pregnancy is a guide for any physician facing the challenge of caring for pregnant women with cardiovascular diseases. Among the new concepts compared to 2011, are recommendations to classify maternal risk due to the modified World Health Organization (mWHO) classification, introduction of the pregnancy heart team, guidance on assisted reproductive therapy, specific recommendations on anticoagulation for low-dose and high-dose requirements of vitamin K antagonists and the potential use of bromocriptine in peripartum cardiomyopathy...
December 2018: Herz
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