Abstract
Introduction: Heart failure (HF) is among the leading causes of morbidity and mortality worldwide. Several conditions trigger left ventricular chronic pressure or volume overload, hypertrophy, systolic and diastolic dysfunction, leading to cardiac remodeling and a rapid progression toward HF. Therapeutic interventions elicit reverse remodeling (RR), a highly variable myocardial response that ranges from none to total ventricular structural/functional recovery. However, HF patients present several comorbidities and medications that mask a comprehensive molecular knowledge of RR and hinder the identification of potential biomarkers of its progression or prognosis. Therefore, instead of using this heterogeneous population or even animal models to understand myocardial remodeling, we propose studying pregnancy-induced cardiovascular remodeling and postpartum-induced RR. Objectives: To assess cardiovascular functional and structural adaptations during pregnancy and in postpartum, characterizing the associated molecular changes; as well as to explore the impact of hypertension, obesity and diabetes on these processes. Methods: We will perform echocardiography and assess endothelial function and arterial stiffness (EndoPAT® and pulse wave velocity, respectively) and assess potential markers of remodeling and RR using plasma and urine samples from pregnant women. To translate to a HF context, we will determine the impact of risk factors (hypertension, obesity and diabetes) by studying subgroups of pregnant women with these comorbidities. Results: Not applicable. Conclusion: We are convinced that understanding the impact of these comorbidities in such a homogeneous population, such as pregnant women, provides a valuable model to unveil the most relevant pathologic and often masked signaling pathways underlying cardiac remodeling and incomplete RR in a heterogeneous population, such as HF patients. Moreover, we expect to identify potential novel biomarkers of RR progression/prognosis more easily.
Translated title of the contribution | The PERInatal MYocardial Remodeling (PERIMYR) cohort study protocol: A prospective study of cardiac remodeling and “recovery” in pregnancy as a model to understand the impact of comorbidities in cardiac remodeling and reverse remodeling |
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Original language | Portuguese |
Pages (from-to) | 585-596 |
Number of pages | 12 |
Journal | Revista Portuguesa de Cardiologia |
Volume | 42 |
Issue number | 6 |
Early online date | 21 Mar 2023 |
DOIs | |
Publication status | Published - Jun 2023 |
Bibliographical note
Funding Information:This work was supported by João Porto Study Grant from the Portuguese Society of Cardiology, by RTP Maratona da Saúde 2017 and by national funds through FCT - Portuguese Foundation for Science and Technology, under the scope of the Cardiovascular R&D Center - UnIC (UIDB/00051/2020 and UIDP/00051/2020). A.F. Ferreira and M.J. Azevedo are supported by Foundation for Science and Technology ( SFRH/BD/138925/2018 and SFRH/BD/144982/2019 , respectively).
Publisher Copyright:
© 2023 Sociedade Portuguesa de Cardiologia
Funding
This work was supported by João Porto Study Grant from the Portuguese Society of Cardiology, by RTP Maratona da Saúde 2017 and by national funds through FCT - Portuguese Foundation for Science and Technology, under the scope of the Cardiovascular R&D Center - UnIC (UIDB/00051/2020 and UIDP/00051/2020). A.F. Ferreira and M.J. Azevedo are supported by Foundation for Science and Technology ( SFRH/BD/138925/2018 and SFRH/BD/144982/2019 , respectively).
Funders | Funder number |
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Fundação para a Ciência e a Tecnologia | SFRH/BD/144982/2019, SFRH/BD/138925/2018 |
Fundação para a Ciência e a Tecnologia | |
Sociedade Portuguesa de Cardiologia | |
University of Nicosia | UIDP/00051/2020, UIDB/00051/2020 |
University of Nicosia |
Keywords
- Cardiac function
- Cardiovascular remodeling
- Comorbidities
- Diabetes
- Hemodynamic overload
- Hypertension
- Obesity
- Post-partum
- Pregnancy
- Pregnant woman
- Reverse remodeling