Perinatal asphyxia and cardiac abnormalities

Dattilo, Giuseppe; Tulino, Viviana; Tulino, Domenico; Lamari, Annalisa; Falanga, Gabriella; Marte, Filippo; Patanè, Salvatore

doi:10.1016/j.ijcard.2009.01.032

Cited by 14 publications

(5 citation statements)

References 6 publications

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“…Other pathologies, such as cardiomegaly, have been described [ 67 ], including electrocardiogram abnormalities, signs of myocardial ischemia, arrhythmias, atrioventricular valve dysfunction, sustained sinus bradycardia, and decreased ventricular contractility [ 68 , 69 ].…”

Section: Cardiovascular Alterations and Multiorgan Dysfunctionmentioning

confidence: 99%

Pathophysiology of Perinatal Asphyxia in Humans and Animal Models

et al. 2022

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Perinatal asphyxia is caused by lack of oxygen delivery (hypoxia) to end organs due to an hypoxemic or ischemic insult occurring in temporal proximity to labor (peripartum) or delivery (intrapartum). Hypoxic–ischemic encephalopathy is the clinical manifestation of hypoxic injury to the brain and is usually graded as mild, moderate, or severe. The search for useful biomarkers to precisely predict the severity of lesions in perinatal asphyxia and hypoxic–ischemic encephalopathy (HIE) is a field of increasing interest. As pathophysiology is not fully comprehended, the gold standard for treatment remains an active area of research. Hypothermia has proven to be an effective neuroprotective strategy and has been implemented in clinical routine. Current studies are exploring various add-on therapies, including erythropoietin, xenon, topiramate, melatonin, and stem cells. This review aims to perform an updated integration of the pathophysiological processes after perinatal asphyxia in humans and animal models to allow us to answer some questions and provide an interim update on progress in this field.

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Section: Cardiovascular Alterations and Multiorgan Dysfunctionmentioning

confidence: 99%

Pathophysiology of Perinatal Asphyxia in Humans and Animal Models

et al. 2022

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“…The cardiovascular instability is common in patients with HIE and the causes are multifactorial. In fact, transient myocardial ischemia and myocardial dysfunction occurs in two-thirds of the infants with moderate to severe perinatal asphyxia ( 43 , 44 ).…”

Section: Echocardiographic Assessment During Transition Circulation Amentioning

confidence: 99%

Echocardiographic Evaluation of Transitional Circulation for the Neonatologists

Singh

Tissot

2018

Front. Pediatr.

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The hemodynamic changes during the first few breaths after birth are probably the most significant and drastic adaptation in the human life. These changes are critical for a smooth transition of fetal to neonatal circulation. With the cord clamping, lungs take over as the source of oxygenation from placenta. A smooth transition of circulation is a complex mechanism and primarily depends upon the drop in pulmonary vascular resistance (PVR) and increase in systemic vascular resistance (SVR). Understanding the normal transition physiology and the adverse adaptation is of utmost importance to the clinicians looking after neonates. It may have a significant influence on the presentation of congenital heart defects (CHDs) in infants. Bedside echocardiography may help in understanding the transition physiology, especially the hemodynamic changes and shunting across ductus arteriosus and foramen ovale, and it may play an important role in making judicious clinical decisions based upon the altered physiology.

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“…One study reported abnormalities including evidence of necrosis and phagocytosis, as well as the presence of contraction band necrosis [aggregated clumps of disorganized actin–myosin filaments ( 16 , 24 , 25 , 37 )] in the hearts of asphyxiated near-term lambs ( 8 , 15 , 26 , 35 ). Human studies on non-surviving asphyxiated newborns have also reported the appearance of cardiac abnormalities ( 27 , 32 , 38 ), including right ventricular dilation, ventricular hypertrophy, persistent atrial shunting, and papillary muscle necrosis ( 39 , 40 ). Understanding how to provide this support is hampered by a distinct lack of experimental data on the structural and functional effects of intrapartum asphyxia on the heart.…”

Section: The Multi-organ Effects Of Intrapartum Asphyxiamentioning

confidence: 99%

Understanding the Full Spectrum of Organ Injury Following Intrapartum Asphyxia

et al. 2017

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Birth asphyxia is a significant global health problem, responsible for ~1.2 million neonatal deaths each year worldwide. Those who survive often suffer from a range of health issues including brain damage—manifesting as cerebral palsy (CP)—respiratory insufficiency, cardiovascular collapse, and renal dysfunction, to name a few. Although the majority of research is directed toward reducing the brain injury that results from intrapartum birth asphyxia, the multi-organ injury observed in surviving neonates is of equal importance. Despite the advent of hypothermia therapy for the treatment of hypoxic–ischemic encephalopathy (HIE), treatment options following asphyxia at birth remain limited, particularly in low-resource settings where the incidence of birth asphyxia is highest. Furthermore, although cooling of the neonate results in improved neurological outcomes for a small proportion of treated infants, it does not provide any benefit to the other organ systems affected by asphyxia at birth. The aim of this review is to summarize the current knowledge of the multi-organ effects of intrapartum asphyxia, with particular reference to the findings from our laboratory using the precocial spiny mouse to model birth asphyxia. Furthermore, we reviewed the current treatments available for neonates who have undergone intrapartum asphyxia, and highlight the emergence of maternal dietary creatine supplementation as a preventative therapy, which has been shown to provide multi-organ protection from birth asphyxia-induced injury in our preclinical studies. This cheap and effective nutritional supplement may be the key to reducing birth asphyxia-induced death and disability, particularly in low-resource settings where current treatments are unavailable.

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Perinatal asphyxia and cardiac abnormalities

Cited by 14 publications

References 6 publications

Pathophysiology of Perinatal Asphyxia in Humans and Animal Models

Pathophysiology of Perinatal Asphyxia in Humans and Animal Models

Echocardiographic Evaluation of Transitional Circulation for the Neonatologists

Understanding the Full Spectrum of Organ Injury Following Intrapartum Asphyxia

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