Cardiovascular Remodeling and Dysfunction Across a Range of Growth Restriction Severity in Small for Gestational Age Infants　– Implications for Fetal Programming –

Akazawa, Yohei; Hachiya, Akira; Yamazaki, Shoko; Kawasaki, Yoichiro; Nakamura, Chizuko; Takeuchi, Yusuke; Kusakari, Mai; Miyosawa, Yukihide; Kamiya, Motoko; Motoki, Noriko; Koike, Kenichi; Nakamura, Tomohiko

doi:10.1253/circj.cj-16-0352

Cited by 22 publications

(23 citation statements)

References 38 publications

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“…Our study aimed to identify those parameters which describe and announce cardiac change in order to identify patients that might be at risk for persistent cardiac abnormalities. IUGR neonates had smaller anthropometric measurements compared to AGA infants, as reported by previous researches [14,25]. The condition was more frequent in female newborns in our study (p<0.05), consistent with literature findings [26].…”

Section: Discussionsupporting

confidence: 92%

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Cardiac left heart morphology and function in newborns with intrauterine growth restriction: relevance for long-term assessment

et al. 2019

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Aim: To asses the cardiac morphology and functional changes specific for newborns from intrauterine growth restriction (IUGR) pregnancies.Material and method: A cohort of IUGR infants were evaluated by serial echocardiographies at delivery and at the first and six months follow-ups. IUGR newborn delivery status was compared to that of newborns in the control group according to gestational age (AGA).Results: Left heart measurements were significantly lower in IUGR newborns compared to AGA babies. Left ventricular size increased at follow-up inthe IUGR group (p<0.05). Systolic dysfunction (the myocardial performance index (MPI)> 0.47) was identified in 40% of the neonates in the IUGR group (16/40), respectively 4.76% in the control group. IUGR neonates had a significantly increased proportion of systolic malfunction (p=0.004).Conclusion: IUGR patients had reduced left ventricle dimensions compared to AGA babies. The MPI stands out as a marker of leftheart function in newborns. Systolic dysfunction was a hallmark of the cardiac adaptation in IUGR neonates.

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Section: Discussionsupporting

confidence: 92%

“…Infants with IUGR have persistent postnatal cardiac morphological changes such as cardiac septal hypertrophy or left ventricle dilatation [11][12][13]. However, functional changes have not always been documented using conventional echocardiographic parameters [13,14].…”

Section: Introductionmentioning

confidence: 99%

Cardiac left heart morphology and function in newborns with intrauterine growth restriction: relevance for long-term assessment

et al. 2019

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“…Intrauterine growth restriction (IUGR) is a common pregnancy complication that arises when the foetus does not achieve its growth potential and affects 5%‐10% of all pregnancies . Recent evidence demonstrated that IUGR is associated with foetal cardiovascular remodelling (CVR) which may eventually result in a cardiovascular risk in adulthood …”

Section: Introductionmentioning

confidence: 99%

Mitochondrial implications in human pregnancies with intrauterine growth restriction and associated cardiac remodelling

Guitart‐Mampel

Juárez‐Flores

Youssef

et al. 2019

J Cellular Molecular Medi

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Intrauterine growth restriction (IUGR) is an obstetric complication characterised by placental insufficiency and secondary cardiovascular remodelling that can lead to cardiomyopathy in adulthood. Despite its aetiology and potential therapeutics are poorly understood, bioenergetic deficits have been demonstrated in adverse foetal and cardiac development. We aimed to evaluate the role of mitochondria in human pregnancies with IUGR. In a single‐site, cross‐sectional and observational study, we included placenta and maternal peripheral and neonatal cord blood mononuclear cells (PBMC and CBMC) from 14 IUGR and 22 control pregnancies. The following mitochondrial measurements were assessed: enzymatic activities of mitochondrial respiratory chain (MRC) complexes I, II, IV, I + III and II + III, oxygen consumption (cell and complex I‐stimulated respiration), mitochondrial content (citrate synthase [CS] activity and mitochondrial DNA copy number), total ATP levels and lipid peroxidation. Sirtuin3 expression was evaluated as a potential regulator of bioenergetic imbalance. Intrauterine growth restriction placental tissue showed a significant decrease of MRC CI enzymatic activity ( P < 0.05) and CI‐stimulated oxygen consumption ( P < 0.05) accompanied by a significant increase of Sirtuin3/β‐actin protein levels ( P < 0.05). Maternal PBMC and neonatal CBMC from IUGR patients presented a not significant decrease in oxygen consumption (cell and CI‐stimulated respiration) and MRC enzymatic activities (CII and CIV). Moreover, CS activity was significantly reduced in IUGR new‐borns ( P < 0.05). Total ATP levels and lipid peroxidation were preserved in all the studied tissues. Altered mitochondrial function of IUGR is especially present at placental and neonatal level, conveying potential targets to modulate obstetric outcome through dietary interventions aimed to regulate Sirtuin3 function.

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“…It is widely accepted that a strong link exists between chromosomal abnormalities and IUGR and that IUGR is a potential cause of RDH. [2021]…”

Section: Discussionmentioning

confidence: 99%

Prenatal Diagnosis of Right Dominant Heart in Fetuses

Feng

Zhu

Liang

et al. 2017

Chinese Medical Journal

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Background:Right dominant heart (RDH) in fetuses can occur with a number of cardiac as well as noncardiac anomalies. Analysis of the enlargement of the right cardiac chamber in the fetus remains a major challenge for sonographers and echocardiographers. The aim of this study was to report the experience with prenatal diagnosis of RDH in the fetuses over a 7-year period.Methods:Fetuses with prenatal diagnosis of RDH from July 2009 to July 2016 were evaluated in two different categories: according to the gestational age, Group I (n = 154, second trimester) and Group II (n = 298, third trimester); and according to the fetal echocardiography diagnosis, Group A (n = 452, abnormal cardiac structure) and Group B (n = 90, normal cardiac structure). Differences in categorical variables were assessed by Chi-square exact test and continuous variables were evaluated by independent Student's t-test or Mann–Whitney U-test depending on parametric or nonparametric nature of the data.Results:Over a 7-year period, 452 fetuses were referred for the assessment of suspected RDH. Left-sided obstructive lesions were observed most frequently in the fetuses with RDH. When comparing Group I with Group II and Group A with Group B, the latter groups exhibited significant differences in the right/left ventricle (RV/LV) ratio (1.435 vs. 1.236, P = 0.002; 1.309 vs. 1.168, P = 0.047), RV width Z-score (1.626 vs. 1.104, P < 0.001; 1.553 vs. 0.814, P = 0.014), and above +2 cutoff percentages (14.3% vs. 22.5%; P = 0.038; 21.5% vs. 12.2%, P = 0.046). Multivariable logistic regression revealed no variables associated with perinatal survival.Conclusions:The study demonstrates that RDH warrants careful attention to the possible presence of a structural cardiac anomaly, especially left-sided obstructive lesions. A diagnosis of RDH is best supported by a combination of the RV Z-score and RV/LV ratio. Most of the fetuses with RDH and structurally normal hearts had favorable outcomes.

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Cardiovascular Remodeling and Dysfunction Across a Range of Growth Restriction Severity in Small for Gestational Age Infants　– Implications for Fetal Programming –

Cited by 22 publications

References 38 publications

Cardiac left heart morphology and function in newborns with intrauterine growth restriction: relevance for long-term assessment

Cardiac left heart morphology and function in newborns with intrauterine growth restriction: relevance for long-term assessment

Mitochondrial implications in human pregnancies with intrauterine growth restriction and associated cardiac remodelling

Prenatal Diagnosis of Right Dominant Heart in Fetuses

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Cardiovascular Remodeling and Dysfunction Across a Range of Growth Restriction Severity in Small for Gestational Age Infants – Implications for Fetal Programming –

Cited by 22 publications

References 38 publications

Cardiac left heart morphology and function in newborns with intrauterine growth restriction: relevance for long-term assessment

Cardiac left heart morphology and function in newborns with intrauterine growth restriction: relevance for long-term assessment

Mitochondrial implications in human pregnancies with intrauterine growth restriction and associated cardiac remodelling

Prenatal Diagnosis of Right Dominant Heart in Fetuses

Contact Info

Product

Resources

About

Cardiovascular Remodeling and Dysfunction Across a Range of Growth Restriction Severity in Small for Gestational Age Infants　– Implications for Fetal Programming –