Maternal Vascular Dysfunction in Congenital Heart Defects

IF 0.3 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Congenital Heart Disease Pub Date : 2023-01-01 DOI:10.32604/chd.2023.030511

Yanli Liu, Fengzhen Han, Jian Zhuang, Yanqiu Ou, Yanji Qu, Yanyan Lin, Weina Zhang, Haiping Wang, Liping Huang

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Abstract

Background: Research on fetal congenital heart defect (CHD) mostly focuses on etiology and mechanisms. However, studies on maternal complications or pathophysiology are limited. Our objective was to determine whether vascular dysfunction exists in pregnant women carrying a fetus with congenital heart defects. Methods: We conducted a case-control study. 27 cases of pregnant women carrying a fetus with major CHD admitted to our hospital for delivery between April 2021 and August 2022 were selected. Every case was matched with about 2 pregnant complication-free controls without fetal abnormalities. The proangiogenic and anti-angiogenic factors and pregnancy outcomes were compared. Results: The proangiogenic factors include vascular endothelial growth factor (VEGF) and placental growth factor (PlGF). The anti-angiogenic factors involve soluble fms-like tyrosine kinase 1 (sFlt-1) and soluble endoglin (sEng). No differences were found in maternal plasma concentrations of PlGF, VEGF, and sFlt-1 between case-control groups when analyzed at 36 weeks ≤ gestational age (GA) < 39 weeks and 39 weeks ≤ GA ≤ 41 weeks. The concentrations of sEng in maternal plasma in the fetal CHD group were significantly higher than those in the control group: 0.60 (0.77) vs. 0.32 (0.26) ng/ml at 36 weeks ≤ GA < 39 weeks, p = 0.001 and 0.75 (0.55) vs. 0.28 (0.27) ng/ml at 39 weeks ≤ GA ≤ 41 weeks, p < 0.001. Conclusion: Vascular dysfunction exists in pregnant women with fetal congenital heart defects, manifesting significantly elevated sEng concentration at delivery.

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先天性心脏缺陷的母体血管功能障碍

背景:胎儿先天性心脏缺陷(CHD)的研究主要集中在病因和机制方面。然而，对产妇并发症或病理生理的研究有限。我们的目的是确定血管功能障碍是否存在于携带先天性心脏缺陷胎儿的孕妇。方法:采用病例-对照研究。选择2021年4月至2022年8月在我院住院分娩的27例重度冠心病孕妇。每例患者均与2例无妊娠并发症、无胎儿畸形的对照组配对。比较促血管生成因子和抗血管生成因子及妊娠结局。结果:促血管生成因子包括血管内皮生长因子(VEGF)和胎盘生长因子(PlGF)。抗血管生成因子包括可溶性纤维样酪氨酸激酶1 (sFlt-1)和可溶性内啡肽(sEng)。在36周≤胎龄(GA) < 39周和39周≤GA≤41周时，病例对照组之间血浆PlGF、VEGF和sFlt-1浓度无差异。胎儿CHD组孕妇血浆sEng浓度显著高于对照组:36周≤GA < 39周时0.60 (0.77)vs 0.32 (0.26) ng/ml, p = 0.001; 39周≤GA≤41周时0.75 (0.55)vs 0.28 (0.27) ng/ml, p < 0.001。结论:胎儿先天性心脏缺陷孕妇存在血管功能障碍，分娩时表现为sEng浓度明显升高。

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来源期刊

Congenital Heart Disease CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

0.40

自引率

33.30%

发文量

审稿时长

6-12 weeks

期刊介绍： Congenital Heart Disease is an open-access journal focusing on congenital heart disease in children and adults. Though the number of infants born with heart disease each year is relatively small (approximately 1% of the population), advances in treating such malformations have led to increased life spans for this population. Consequently, today most patients treated for congenital heart disease are over the age of 20. What are the special needs of adults with congenital heart disease? What are the latest developments in the care of the fetus, infants, and children? Who should treat these patients? How should they be treated? Congenital Heart Disease focuses on these questions and more. Conceived as a forum for the most up-to-date information on congenital heart disease, the journal is led by Editor-in-Chief Vladimiro L. Vida, MD, Ph.D., Professor in Cardiac Surgery, University of Padua in Italy, as well as an international editorial board. Congenital Heart Disease publishes articles on heart disease as it relates to the following areas: • Basic research of congenital heart disease • Clinical pediatric and adult cardiology • Cardiac imaging • Preventive cardiology • Diagnostic and interventional cardiac catheterization • Electrophysiology • Surgery • Long-term follow-up, particularly as it relates to older children and adult congenital heart disease • Exercise and exercise physiology in the congenital patient • Post-op and critical care • Common disorders such as syncope, chest pain, murmurs, as well as acquired disorders such as Kawasaki syndrome The journal includes clinical studies, invited editorials, state-of-the-art reviews, case reports, articles focusing on the history and development of congenital heart disease, and CME material. Occasional issues focus on special topics. Readership: Congenital Heart Disease was created for pediatric cardiologists; adult cardiologists who care for patients with congenital heart disease; pediatric and pediatric cardiology nurses; surgeons; radiologists; anesthesiologists; critical care physicians and nurses; and adult support staff involved in the care of patients with congenital heart disease.