怀孕期间的心血管疾病:当两个心跳为一个时
Chiara Tognola1, Filippo Brucato2, Alessandro Maloberti1,2
1Clinical Cardiology Unit, De Gasperis Cardio Center, Niguarda Hospital, 20162 Milan, Italy.
Diagnostics (Basel, Switzerland)
|November 27, 2025
概括
怀孕期间的心血管疾病带来了重大风险. 本综述综合了关于管理心肌病,抗凝血和高血压的证据,强调为改善孕产妇结果提供多学科护理.
科学领域:
- 心脏病学和产科 产科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 怀孕期间的心血管健康
背景情况:
- 心血管疾病 (CVD) 是全球导致孕产妇发病和死亡的主要原因.
- 怀孕期间的生理变化可以加剧现有的心血管疾病或揭示亚临床条件.
- 怀孕作为一种自然的心血管压力测试.
研究的目的:
- 批判性地审查当前的证据和指导方针来管理与怀孕有关的心血管疾病.
- 专注于病理生理机制,诊断挑战和治疗争议.
- 分析当代高影响临床领域的管理策略.
主要方法:
- 对当代证据和国际准则进行全面审查.
- 讨论的重点是围产部/先前存在的心肌病,机械假体门的抗凝剂,以及怀孕的高血压疾病.
- 欧洲心脏病学会 (ESC) 2025年和美国心脏协会 (AHA) 2020年建议的比较分析.
主要成果:
- 共享的病理生理机制包括内皮功能障碍,血管生成失衡和全身炎症.
- 在ESC和AHA指南之间存在广泛的共识,在抗凝目标和产后监测方面存在一些差异.
- 最近的试验 (CHAP,WILL) 为高血压疾病和长期预防提供了新的见解.
结论:
- 通过怀孕心脏团队提供多学科护理对于整合产科和心脏病专业知识至关重要.
- 结构化的产后随访途径对于改善怀孕相关心血管疾病妇女的结果至关重要.
- 解决共同的机制和指导方针的差异可以改善母亲的心血管健康.
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