Cardiovascular Catastrophes in the Obstetric Population

Dubbs, Sarah B.; Tewelde, Semhar Z.

doi:10.1016/j.emc.2015.04.001

Cited by 5 publications

(3 citation statements)

References 89 publications

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“…When there is suspicion of lower extremity DVT, manifesting as extremity pain or swelling, the recommended initial diagnostic test is compression ultrasonography of the proximal veins. If there is still a suspicion of iliac vein thrombosis despite negative results, further evaluation with non-gadolinium-enhanced magnetic resonance venography is advised ( 45 ).…”

Section: Resultsmentioning

confidence: 99%

Thromboembolism in peripartum cardiomyopathy: a systematic review

Radakrishnan,

Dokko,

Pastena

et al. 2024

J Thorac Dis

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Background Women with peripartum cardiomyopathy (PPCM) are at an increased risk of arterial and venous thromboembolic events. The review summarizes the evidence on the incidence of thromboembolic complications in women with PPCM, diagnostic approaches, related outcomes, and effects of therapies that have been used. Methods English articles were retrieved from Web of Science and PubMed using search terms to capture studies related to PPCM (or postpartum cardiomyopathy) and all combinations of thrombosis- and embolism-related keywords. A total of 347 articles from PubMed and 85 from Web of Science were obtained, and after removing duplicates, 327 articles were screened for original data and classified into four domains: epidemiology, risk factors, diagnosis, and therapy of thromboembolism in PPCM. Ultimately, 30 articles were included. Data were synthesized in summary tables for each domain. Results Studies in the United States and Europe reported varying incidence for thromboembolism in PPCM, up to 14% in 6 months. Risk factors include elevated levels of coagulation factors, decreased protein C and S activity, decreased fibrinolysis, and a low left ventricular ejection fraction (LVEF). Cesarean delivery and post-operative status were correlated with a higher incidence of thromboembolic complications. Diagnosis relied mostly on ultrasonography and magnetic resonance and depended on the suspected location of thrombus. Anticoagulation has been used mostly for PPCM patients with a reduced LVEF, with the duration varying across guidelines and healthcare systems. Unfractionated heparin and low molecular weight heparin (LMWH) were considered safe choices during pregnancy, while warfarin and novel oral anticoagulants (NOACs) were used postpartum. The association of bromocriptine with risk of thromboembolic complications remains debated. Conclusions There are important gaps in our understanding of the epidemiology, risk stratification, and optimal secondary prevention of thromboembolism in PPCM. Larger prospective studies with detailed phenotyping are required.

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Section: Resultsmentioning

confidence: 99%

Thromboembolism in peripartum cardiomyopathy: a systematic review

Radakrishnan,

Dokko,

Pastena

et al. 2024

J Thorac Dis

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“…Cardiac and circulatory failure may occur in pregnancy and the early postpartum as a complication of underlying cardiac or vascular diseases but also as a complication of obstetric A c c e p t e d M a n u s c r i p t catastrophes [1]. Cardiac arrest remains a rare event that must be anticipated by availability of resuscitation supports and caregivers' formation [2,3].…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular emergencies and cardiac arrest in a pregnant woman

Ducloy-Bouthors

Gonzalez-Estevez

Constans

et al. 2016

Anaesthesia Critical Care & Pain Medicine

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“…Coronary artery disease and stroke account for about 80% of CVD deaths [2]. In the United States, 80% of people aged above 60 are affected by CVD, whose life qualities are severely compromised [3].…”

Section: Introductionmentioning

confidence: 99%

Selenium Inhibits Homocysteine-Induced Endothelial Dysfunction and Apoptosis via Activation of AKT

Ren

Mu²,

Ma³

et al. 2016

Cell Physiol Biochem

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Background/Aims: Endothelial cells are crucial in vascular homeostasis. Dysfunction of endothelial cells is involved in the development of cardiovascular diseases (CVD). High plasma homocysteine (Hcy) correlates with CVD while selenium supplementation counteracts development of CVD. However, the underlying mechanism remained unclear. Here, we investigated the effects of selenium on homocysteine-induced endothelial dysfunction. Methods: An animal model of Hcy-induced endothelial dysfunction was established by intragastric administration of L-methionine. Plasma NO and von Willebrand factor (vWF) were quantified using NO assay and ELISA kit respectively. Relaxation was measured in thoracic aortic ring assays. Cell viability and migration were detected by Cell Counting Kit-8 and BioCoat cell migration chambers respectively. Cellular apoptosis was determined by Annexin V-FITC apoptosis kit. Results: Selenium prevented homocysteine-induced endothelial injury and impairment of endothelium-dependent relaxation. Selenium reversed the impaired viability and migration of endothelial cells induced by homocysteine in a dose-dependent manner. Selenium inhibited the apoptosis of endothelial cells induced by homocysteine, through downregulating of Caspase-3 activity and expression of Caspase-3 and Bax, and by stimulating Bcl-2 expression. Selenium reversed the homocysteine-induced reduction of NO release, and increased the expression and phosphoylation of endothelial nitric oxide synthetase (eNOS) in a dose-dependent manner. Moreover, selenium enhanced AKT phosphorylation, and selenium-induced phosphorylation and expression of eNOS were inhibited by AKT inhibition. NO production, cell viability and migration rescued by selenium were inhibited, while cell apoptosis was reversed by AKT inhibition. Conclusion: Selenium protected against homocysteine-induced dysfunction and apoptosis of endothelial cells through AKT pathway. The observations may provide novel therapeutic opportunities in the treatment of CVD.

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Cardiovascular Catastrophes in the Obstetric Population

Cited by 5 publications

References 89 publications

Thromboembolism in peripartum cardiomyopathy: a systematic review

Thromboembolism in peripartum cardiomyopathy: a systematic review

Cardiovascular emergencies and cardiac arrest in a pregnant woman

Selenium Inhibits Homocysteine-Induced Endothelial Dysfunction and Apoptosis via Activation of AKT

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