Endothelial Dysfunction in Pregnancy Complications

Kornacki, Jakub; Gutaj, Paweł; Kalantarova, Anastasia; Sibiak, Rafał; Jankowski, Maurycy; Wender-Ożegowska, Ewa

doi:10.3390/biomedicines9121756

Cited by 14 publications

(21 citation statements)

References 191 publications

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“…A possible link between these two diseases should be evaluated by future studies. One plausible hypothesis to explain the possible link between HELLP and Takotsubo syndrome is an interplay between endothelial abnormalities as recently discussed ( 13 ). In HELLP syndrome and during pre-eclampsia there is an imbalance of vasoconstriction and vasodilation mediators mainly at the placental level, and in Takotsubo syndrome dysfunctions in the microcirculation have been documented ( 14 ), suggesting that abnormal regulation of vasoconstriction/vasodilation in the microcirculation may underlie both syndromes.…”

Section: Discussionmentioning

confidence: 99%

Inverted Takotsubo Syndrome With HELLP Syndrome: A Case Report

Gabarre

Ruiz

Chenevier‐Gobeaux

et al. 2022

Front. Cardiovasc. Med.

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BackgroundTakotsubo syndrome is an acute cardiac condition involving sudden, transient apical ballooning of the left ventricle of the heart that may be triggered by emotional stress and some non-cardiac conditions. Its diagnosis is based on clinical presentation, electrocardiogram, cardiac imaging and biomarkers.Case SummaryHere, we present a novel and original case report of a patient presenting very soon in the post-partum period with an unusual form of Takotsubo syndrome without clinical symptoms of cardiac disease and accompanied by HELLP syndrome. The overall dynamics of the changes in troponin I, troponin T and NT-proBNP levels after delivery were generally similar, but the amount of troponin I was much greater than that of troponin T and troponin I was already elevated before delivery. NT-proBNP levels peaked around the same time as the troponins and the peak concentration was within the same range as that of troponin I.DiscussionOur findings indicate that assaying circulating cardiac biomarkers, especially troponin I and NT-proBNP, may be a useful complement to non-invasive cardiac imaging including transthoracic echocardiography and cardiovascular magnetic resonance imaging, in the diagnosis of Takotsubo syndrome. They illustrate the importance of cardiac biomarkers in assisting diagnosis of this disease.

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Section: Discussionmentioning

confidence: 99%

Inverted Takotsubo Syndrome With HELLP Syndrome: A Case Report

Gabarre

Ruiz

Chenevier‐Gobeaux

et al. 2022

Front. Cardiovasc. Med.

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“…These observed microvascular morphological changes in retinal characteristics alluded to potential systemic microcirculation pathology in pregnant women grappling with suboptimal hemodynamic circulation, 51 inflammation, 52 and endothelial dysfunction 53 in vivo. However, it is essential to acknowledge the inherent limitations of drawing definitive conclusions from these findings due to the cross-sectional nature of the study.…”

Section: Women's Fertilitymentioning

confidence: 94%

Retinal Vascular Imaging Application in Women’s Reproductive Health: Clinical Implications and Future Directions

Lim,

2024

Maternal Fetal Med

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Over the past two decades, population-based studies employing semiautomatic computer-assisted programs have uncovered associations between retinal microvascular features and various systemic conditions. As the recognition of retinal imaging in cardiometabolic health grows, there is increasing evidence supporting its application in women’s health, particularly during the reproductive age. This review aims to summarize the indications of retinal imaging in women’s health and intergenerational health, where suboptimal retinal imaging has been found to mirror pathological systemic changes, such as suboptimal hemodynamic circulation, inflammation, endothelial dysfunction, oxidative stress, and hypoxia in vivo. Findings from Singapore Growing Up in Singapore Towards Healthy Outcomes and Singapore Preconception Study of Long-Term Maternal and Child Outcomes cohorts have reported serial changes in retinal conventional microvascular features (e.g., retinal arteriolar narrowing, retinal venular widening) and retinal geometric microvascular features (e.g., sparse fractal dimension, enlarged branching angle, and increased curvature tortuosity) during the preconception and antenatal phases. These morphological abnormalities were found to be related to female fertility, maternal antenatal health conditions, postnatal maternal cardiometabolic health, and intergenerational health in the fetus. Given the compelling evidence of the ability to detect microvascular changes through noninvasive methods at an early stage, retinal imaging holds the potential to facilitate timely interventions, mitigate the progression of complications, and prevent adverse pregnancy outcomes. Looking ahead, the convergence of artificial intelligence and advanced imaging techniques heralds a promising era in women’s health research and clinical practice.

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“…CCL2, also known as monocyte chemoattractant protein-1 (MCP-1), is a form of senescence-associated secretory phenotype (SASP) that serves as a marker for vascular endothelial cell failure and has inflammatory properties [ 11 ]. This suggests a strong correlation between HIP and its negative effects on pregnancy, primarily due to the malfunction of umbilical vein endothelial cells [ 12 ]. Therefore, exploring the mechanisms related to hyperglycemia and umbilical vein endothelial cell dysfunction may provide a new solution for preventing and treating hyperglycemia in pregnancy and other pregnancy complications and adverse pregnancy outcomes caused by it.…”

Section: Introductionmentioning

confidence: 99%

High Glucose Promotes and Aggravates the Senescence and Dysfunction of Vascular Endothelial Cells in Women with Hyperglycemia in Pregnancy

Zheng,

Li,

2024

Biomolecules

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Hyperglycemia in pregnancy (HIP) is linked to fetoplacental endothelial dysfunction, which might be a result of hyperglycemia. Hyperglycemia is associated with cell senescence; however, the role and mechanism of high glucose and cell senescence in HIP endothelial cell failure are largely unknown. Our study discovered that human umbilical vein endothelial cells (HUVECs) obtained from HIP pregnant women exhibit excessive senescence, with significantly elevated expression of senescence markers senescence-associated beta-galactosidase (SA-β-gal), p16, p21, and p53. Subsequently, we found that exposing primary HUVECs and cell lines to high glucose resulted in an increase in the synthesis of these senescence indicators, similar to what had been observed in pregnant women with HIP. A replicate senescence model and stress-induced premature senescence (SIPS) model showed higher amounts of vascular damage indicators, including von Willebrand factor (vWF), chemotactic C-C motif chemokine ligand 2 (CCL2), intercellular adhesion molecule 1 (ICAM-1), along with the anti-apoptotic protein BCL2. However, lower expressions of the pro-apoptotic component BAX, in addition to defective proliferation and tubulogenesis, were seen. Further studies indicated that hyperglycemia can not only induce these alterations in HUVECs but also exacerbate the aforementioned changes in both aging HUVECs. The experiments outlined above have also been validated in pregnant women with HIP. Collectively, these data suggest that exposure to high glucose accelerates cell senescence-mediated vein endothelial cell dysfunction, including excessive inflammation, cell adhesion, impaired angiogenesis, and cell proliferation possibly contributing to pregnancy complications and adverse pregnancy outcomes.

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Endothelial Dysfunction in Pregnancy Complications

Cited by 14 publications

References 191 publications

Inverted Takotsubo Syndrome With HELLP Syndrome: A Case Report

Inverted Takotsubo Syndrome With HELLP Syndrome: A Case Report

Retinal Vascular Imaging Application in Women’s Reproductive Health: Clinical Implications and Future Directions

High Glucose Promotes and Aggravates the Senescence and Dysfunction of Vascular Endothelial Cells in Women with Hyperglycemia in Pregnancy

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