Assisted reproductive technology: what are the cardiovascular risks for women?

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Carolyn Guan, Carla Rodriguez, Petal Elder-Odame, Anum S Minhas, Salman Zahid, Valerie L Baker, Chrisandra L Shufelt, Erin D Michos
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引用次数: 0

Abstract

Introduction: Infertility affects 15% of women of reproductive age in the United States. The use of assisted reproductive technology (ART) has been rising globally, as well as a growing recognition of reproductive factors that increase risk for cardiovascular disease (CVD).

Areas covered: Women with infertility who use ART are more likely to have established CVD risk factors, such as obesity, dyslipidemia, hypertension, and diabetes. They are also more likely to experience adverse pregnancy outcomes, which are associated with both peripartum and long-term cardiovascular complications. ART may lead to increased cardiometabolic demands due to ovarian stimulation, pregnancy itself, and higher rates of multifetal gestation. Preeclampsia risk appears greater with frozen rather than fresh embryo transfers.

Expert opinion: The use of ART and its association with long term CVD has not been well-studied. Future prospective and mechanistic studies investigating the association of ART and CVD risk may help determine causality. Nevertheless, CVD risk screening is critical pre-pregnancy and during pregnancy to reduce pregnancy complications that elevate future CVD risk. This also offers a window of opportunity to connect patients to longitudinal care for early management of cardiometabolic risk profile and initiation of preventive lifestyle and pharmacotherapy interventions tailored toward patient-specific risk factors.

辅助生殖技术:女性的心血管风险是什么?
引言:在美国,15%的育龄妇女患有不孕不育。辅助生殖技术(ART)的使用在全球范围内不断增加,人们也越来越认识到增加心血管疾病(CVD)风险的生殖因素。涵盖的领域:使用辅助生殖技术的不孕妇女更有可能存在心血管疾病的风险因素,如肥胖、血脂异常、高血压和糖尿病。她们也更有可能经历不良妊娠结局,这与围产期和长期心血管并发症有关。ART可能由于卵巢刺激、妊娠本身和多胎妊娠率较高而导致心脏代谢需求增加。冷冻胚胎移植比新鲜胚胎移植的先兆子痫风险更大。专家意见:ART的使用及其与长期CVD的关系尚未得到很好的研究。未来对ART和CVD风险的相关性进行前瞻性和机制性研究可能有助于确定因果关系。尽管如此,CVD风险筛查在怀孕前和怀孕期间至关重要,以减少增加未来CVD风险的妊娠并发症。这也提供了一个机会之窗,将患者与纵向护理联系起来,以早期管理心脏代谢风险状况,并启动针对患者特定风险因素的预防性生活方式和药物治疗干预措施。
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来源期刊
Expert Review of Cardiovascular Therapy
Expert Review of Cardiovascular Therapy CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
3.70
自引率
0.00%
发文量
82
期刊介绍: Expert Review of Cardiovascular Therapy (ISSN 1477-9072) provides expert reviews on the clinical applications of new medicines, therapeutic agents and diagnostics in cardiovascular disease. Coverage includes drug therapy, heart disease, vascular disorders, hypertension, cholesterol in cardiovascular disease, heart disease, stroke, heart failure and cardiovascular surgery. The Expert Review format is unique. Each review provides a complete overview of current thinking in a key area of research or clinical practice.
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