怀孕期间的心血管风险因素会影响产后的心脏和血管逆向重塑
Ana Filipa Ferreira1, Maria João Azevedo2,3,4,5, Juliana Morais1
1Department of Surgery and Physiology, Cardiovascular R&D Centre-UnIC@RISE, Faculdade de Medicina, University of Porto, Porto, Portugal.
概括
患有心血管风险的孕妇在怀孕期间会经历心脏变化. 动脉高血压是影响产后康复的关键因素,CRP和ST2/IL33受体是逆转缩的潜在生物标志物.
科学领域:
- 心脏病学 心脏病学
- 产科 产科 产科 产科 产科
- 生物标志物 生物标志物
背景情况:
- 怀孕期间心血管风险因素 (CVR) 会增加长期心血管疾病的风险.
- 目前的指导方针建议这些妇女延长产后随访 (1年).
- 怀孕涉及显著的心血管改造,需要了解产后逆转改造 (RR).
研究的目的:
- 为了评估怀孕期间心血管改造.
- 为了确定预测产后心脏和血管RR的CVR因素.
- 探索产后缩逆转的潜在生物标志物.
主要方法:
- 76名健康的孕妇和54名高CVR的孕妇的前性队列研究.
- 在多个时间点 (怀孕三季度和产后1-12个月) 进行胸外心声和脉冲波速度 (PWV) 测量.
- 一般化的线性混合效应模型用于分析RR和预测因素,包括C反应蛋白 (CRP) 和ST2/IL33受体水平.
主要成果:
- 在怀孕期间,左心室质量 (LVM),填充压力 (E / e) 和心房体积的显著增加.
- 在产后1个月内观察到的LV体积,LVM和填充压力的快速回归.
- 动脉高血压,吸烟和肥胖预测增加了LVM;高血压,年龄和妊娠糖尿病与PWV相关.
- 高CRP和低ST2/IL33受体水平与较差的LVM回归有关.
结论:
- 怀孕诱导心脏缩和血管变化,具有显著的产后逆转.
- 动脉高血压是一个关键的CVR因素,与产后RR恶化有关.
- CRP和ST2/IL33受体显示出作为监测产后缩逆转的生物标志物的潜力.
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