The PERInatal MYocardial Remodeling (PERIMYR) cohort study protocol: A prospective study of cardiac remodeling and "recovery" in pregnancy as a model to understand the impact of comorbidities in cardiac remodeling and reverse remodeling.
Rev Port Cardiol
; 42(6): 585-596, 2023 06.
Article
em En, Pt
| MEDLINE
| ID: mdl-36958578
ABSTRACT
INTRODUCTION:
Heart failure (HF) is among the leading causes of morbidity and mortality worldwide. Several conditions trigger left ventricular chronic pressure or volume overload, hypertrophy, systolic and diastolic dysfunction, leading to cardiac remodeling and a rapid progression toward HF. Therapeutic interventions elicit reverse remodeling (RR), a highly variable myocardial response that ranges from none to total ventricular structural/functional recovery. However, HF patients present several comorbidities and medications that mask a comprehensive molecular knowledge of RR and hinder the identification of potential biomarkers of its progression or prognosis. Therefore, instead of using this heterogeneous population or even animal models to understand myocardial remodeling, we propose studying pregnancy-induced cardiovascular remodeling and postpartum-induced RR.OBJECTIVES:
To assess cardiovascular functional and structural adaptations during pregnancy and in postpartum, characterizing the associated molecular changes; as well as to explore the impact of hypertension, obesity and diabetes on these processes.METHODS:
We will perform echocardiography and assess endothelial function and arterial stiffness (EndoPAT® and pulse wave velocity, respectively) and assess potential markers of remodeling and RR using plasma and urine samples from pregnant women. To translate to a HF context, we will determine the impact of risk factors (hypertension, obesity and diabetes) by studying subgroups of pregnant women with these comorbidities.RESULTS:
Not applicable.CONCLUSION:
We are convinced that understanding the impact of these comorbidities in such a homogeneous population, such as pregnant women, provides a valuable model to unveil the most relevant pathologic and often masked signaling pathways underlying cardiac remodeling and incomplete RR in a heterogeneous population, such as HF patients. Moreover, we expect to identify potential novel biomarkers of RR progression/prognosis more easily.Palavras-chave
Cardiac function; Cardiovascular remodeling; Comorbidities; Comorbilidades; Diabetes; Diabetes mellitus; Função cardíaca; Gravidez; Grávida; Hemodynamic overload; Hipertensão arterial; Hypertension; Obesidade; Obesity; Post-partum; Pregnancy; Pregnant woman; Pós-parto; Remodelagem cardiovascular; Remodelagem reversa; Reverse remodeling; Sobrecarga hemodinâmica
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Diabetes Mellitus
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Insuficiência Cardíaca
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Hipertensão
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Animals
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Female
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Humans
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Pregnancy
Idioma:
En
/
Pt
Revista:
Rev Port Cardiol
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Portugal