Hemodynamic factors associated with fetal cardiac remodeling in late fetal growth restriction: a prospective study

Rizzo, Giuseppe; Mattioli, C.; Mappa, Ilenia; Bitsadze, Victoria; Khizroeva, J. Kh.; Słodki, Maciej; Makatsarya, A.; D’Antonio, F.

doi:10.1515/jpm-2019-0217

Cited by 37 publications

(41 citation statements)

References 26 publications

(33 reference statements)

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“…In addition, although we focused on postnatal outcomes, in utero analysis using Doppler velocimetry could help further characterize the potential in utero cardiac remodelling and type of FGR associated with changes in hemodynamic flow. [77][78][79] For example, one clinical study demonstrated that in early-onset IUGR fetuses abnormal echocardiography and Doppler readings in the umbilical vein are associated with changes in cardiac morphology. 79 Moreover, studies are also required to address if cannabidiol (the largest non-psychoactive component of cannabis) is safe for fetal and postnatal cardiovascular health.…”

Section: Discussionmentioning

confidence: 99%

Exposure to Δ9-tetrahydrocannabinol during rat pregnancy leads to impaired cardiac dysfunction in postnatal life

2021

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Background Cannabis use in pregnancy leads to fetal growth restriction (FGR), but the long-term effects on cardiac function in the offspring are unknown, despite the fact that fetal growth deficits are associated with an increased risk of developing postnatal cardiovascular disease. We hypothesize that maternal exposure to Δ9-tetrahydrocannabinol (Δ9-THC) during pregnancy will impair fetal development, leading to cardiac dysfunction in the offspring. Methods Pregnant Wistar rats were randomly selected and administered 3 mg/kg of Δ9-THC or saline as a vehicle daily via intraperitoneal injection from gestational days 6 to 22, followed by echocardiogram analysis of cardiac function on offspring at postnatal days 1 and 21. Heart tissue was harvested from the offspring at 3 weeks for molecular analysis of cardiac remodelling. Results Exposure to Δ9-THC during pregnancy led to FGR with a significant decrease in heart-to-body weight ratios at birth. By 3 weeks, pups exhibited catch-up growth associated with significantly greater left ventricle anterior wall thickness with a decrease in cardiac output. Moreover, these Δ9-THC-exposed offsprings exhibited increased expression of collagen I and III, decreased matrix metallopeptidase-2 expression, and increased inactivation of glycogen synthase kinase-3β, all associated with cardiac remodelling. Conclusions Collectively, these data suggest that Δ9-THC-exposed FGR offspring undergo postnatal catch-up growth concomitant with cardiac remodelling and impaired cardiac function early in life. Impact To date, the long-term effects of perinatal Δ9-THC (the main psychoactive component) exposure on the cardiac function in the offspring remain unknown. We demonstrated, for the first time, that exposure to Δ9-THC alone during rat pregnancy results in significantly smaller hearts relative to body weight. These Δ9-THC-exposed offsprings exhibited postnatal catch-up growth concomitant with cardiac remodelling and impaired cardiac function. Given the increased popularity of cannabis use in pregnancy along with rising Δ9-THC concentrations, this study, for the first time, identifies the risk of perinatal Δ9-THC exposure on early postnatal cardiovascular health.

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Section: Discussionmentioning

confidence: 99%

Exposure to Δ9-tetrahydrocannabinol during rat pregnancy leads to impaired cardiac dysfunction in postnatal life

2021

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“…These changes in placental volume are independent from uterine artery Doppler that are usually normal in ICSI pregnancies despite the higher risk to develop pre-eclampsia in such women. A reduction in placental volume may by itself reduce umbilical vein flow, thus influencing cardiac shape [26, 31].…”

Section: Discussionmentioning

confidence: 99%

“…Cardiac measurements were obtained from 2-dimensional images of the 4-chamber view with an angle of 45°-90° between the interventricular septum and the ultrasound beam according to a previously reported technique [24][25][26][27]. Images were optimized to enhance the borders of cardiac walls and cine clips were stored.…”

Section: Ultrasound Assessmentmentioning

confidence: 99%

Fetal Cardiac Remodeling Is Affected by the Type of Embryo Transfer in Pregnancies Conceived by in vitro Fertilization: A Prospective Cohort Study

et al. 2020

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Objective: Pregnancies conceived via intracytoplasmic sperm injection (ICSI) are associated with a higher risk of fetal cardiac remodeling. The aim of this study was to evaluate whether the type of embryo transfer may affect the magnitude of fetal cardiac remodeling in pregnancies conceived via ICSI. Methods: Prospective cross-sectional study including 212 pregnancies conceived by ICSI (111 with frozen and 101 with fresh embryos) and 120 spontaneously conceived gestations. All women underwent ultrasound biometric evaluation, Doppler, and echocardiographic assessment, including evaluation of left and right atrial areas and sphericity index (SI), at 20–24 weeks of gestation. The χ2 and Kruskal-Wallis H tests were used to analyze the data. Results: There was no difference in maternal characteristics, gestational age at ultrasound, Doppler, and fetal weight among the study groups. In pregnancies conceived by ICSI, left and right atrial areas were higher (p < 0.0001) and SI was lower (p < 0.0001) compared to spontaneously conceived pregnancies. Left (p = 0.004) and right (p = 0.023) atrial areas and left (p = 0.036) and right (p = 0.002) SIs were more affected in ICSI pregnancies conceived by fresh embryos. Conclusion: The risk of fetal cardiac remodeling is higher in pregnancies conceived by ICSI and independent from fetal size and Doppler. The magnitude of these changes is affected by the type of ICSI technique and is higher in pregnancies conceived by fresh embryos.

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“…Fetal echocardiography included a comprehensive anatomic and functional evaluation. Cardiac measurements were obtained from two-dimensional images of the four-chamber view with the interventricular septum at an angle between 45° and 90° to the ultrasound beam using a previously reported technique [12]. Images were optimised to enhance the borders of cardiac walls, and cine clips were stored.…”

Section: Ultrasound Assessmentmentioning

confidence: 99%

“…The sphericity index (SI), calculated as the ratio between the end-diastolic mid-basal-apical and transverse lengths, can be easily obtained by standard four chamber view of the fetal heart [9]. The sphericity index is among the most reproducible parameters used to quantify cardiac remodelling and has been shown to be reduced in pregnancies complicated by late FGR and in fetuses of pregnancy from in vitro fertilisation [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Fetal cardiac remodelling in pregnancies complicated by gestational diabetes mellitus: a prospective cohort study

Rizzo¹,

Pietrolucci²,

Mappa³

et al. 2020

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Introduction: Pregnancies complicated by gestational diabetes mellitus (GDM) have a higher risk of fetal and neonatal cardiac remodelling. Our aim was to evaluate the sphericity index (SI), a variable reflecting the severity of cardiac shape changes, in fetuses of GDM mothers and correlate the quality of glycaemic control expressed by glycated haemoglobin (HbA 1c ) levels. Material and methods: This was a prospective cross-sectional study including 276 pregnancies complicated by GDM (185 with good control [HbA 1c ≤ 5.5] and 91with poor control [HbA1c > 5.5]) and 140 uncomplicated gestations. All women underwent ultrasound biometric evaluation, Doppler and echocardiographic assessment, including evaluation of the SI at a median gestational age of 30 weeks. Comparisons among groups were performed. Results: Compared to the control group, fetuses from GDM mothers showed a higher body mass index (p = 0.003), estimated fetal weight (p = 0.037), gestational age at delivery (p = 0.042), birthweight (p = 0.006), and birthweight centile (p = 0.012). There was no difference in maternal age, parity, gestational age at ultrasound, and maternal or fetal Dopplers. In pregnancies with GDM right ventricle SI (1.42 for good control and 1.33 for poor c control) the SIs were higher compared to control pregnancies (1.55; p = 0.001). No difference was found in left ventricle SI (1.51 for good and 1.59 for poor control) when compared to the control group (1.76; p = 0.08). When stratifying the analysis according to glycaemic control, right SI was lower in pregnancies with poor compared to good control (p = 0.002). Conclusions: The risk of fetal cardiac remodelling is higher in pregnancies complicated by GDM, and it is independent of maternal and fetal Doppler. These changes occur at the level of the right ventricle and are influenced by glycaemic control.

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Hemodynamic factors associated with fetal cardiac remodeling in late fetal growth restriction: a prospective study

Cited by 37 publications

References 26 publications

Exposure to Δ9-tetrahydrocannabinol during rat pregnancy leads to impaired cardiac dysfunction in postnatal life

Exposure to Δ9-tetrahydrocannabinol during rat pregnancy leads to impaired cardiac dysfunction in postnatal life

Fetal Cardiac Remodeling Is Affected by the Type of Embryo Transfer in Pregnancies Conceived by in vitro Fertilization: A Prospective Cohort Study

Fetal cardiac remodelling in pregnancies complicated by gestational diabetes mellitus: a prospective cohort study

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