Neural control of blood pressure during pregnancy in humans.
Neural control of blood pressure during pregnancy in humans.
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DOI：
10.1007/s10286-020-00703-3
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发表时间：
2020-10
期刊：
影响因子：
--
通讯作者：
Fu Q
中科院分区：
文献类型：
--
作者：
Hissen SL;Fu Q
先前的显微神经摄影研究发现，肌肉交感神经活动（MSNA）在血压正常的孕妇中增加，在妊娠期高血压和先兆子痫的妇女中甚至更大。在正常妊娠的最后几个月，交感神经激活可能有助于动脉压恢复到非妊娠水平。然而，当交感神经活动过度增加时，高血压就会加重。必须解决的关键问题是交感神经激活是否在妊娠早期发展并在整个妊娠期间保持较高水平，或者这种交感神经过度活跃是否仅发生在足月，为先兆子痫和其他妊娠相关的心血管并发症提供底物。文献综述。我们实验室和其他人最近的工作表明，静息MSNA在怀孕早期增加，在怀孕后期进一步增加，并在健康女性分娩后不久恢复到怀孕前的水平。我们发现，在妊娠早期，在任何临床体征和症状出现之前，表现出过度交感神经激活的妇女，在足月时发展为妊娠高血压。我们还发现corin，一种心房利钠肽转换酶，在母体循环中增加，特别是在妊娠晚期，作为对交感神经活性升高的稳态反应。这些发现为深入了解妊娠期高血压疾病的神经机制提供了重要线索。有了这些知识，可以开始针对适当的病理生理学的早期预防或治疗，这可能会减少孕产妇和胎儿的死亡或发病率，以及妇女在以后的生活中的心血管风险。
Previous microneurographic studies found that muscle sympathetic nerve activity (MSNA) increased in normotensive pregnant women and was even greater in women with gestational hypertension and preeclampsia during the third trimester. It is possible that sympathetic activation during the latter months of normal pregnancy helps return arterial pressure to non-pregnant levels. However, when the increase in sympathetic activity is excessive, hypertension ensues. The key question that must be addressed is whether sympathetic activation develops early during pregnancy and remains high throughout gestation, or whether this sympathetic overactivity only occurs at term, providing the substrate for preeclampsia and other pregnancy-associated cardiovascular complications. Literature review. Recent work from our laboratory and others showed that resting MSNA increased in early-pregnancy, further increased in late-pregnancy, and returned to the pre-pregnancy levels shortly after delivery in healthy women. We found that women who exhibited excessive sympathetic activation during the first trimester, before any clinical signs and symptoms appeared, developed gestational hypertension at term. We also found that corin, an atrial natriuretic peptide-converting enzyme, was increased in the maternal circulation, especially during late pregnancy, as a homeostatic response to elevated sympathetic activity. These findings provide important insight into the neural mechanisms underlying hypertensive disorders during pregnancy. With this knowledge, early prevention or treatment targeted to the appropriate pathophysiology may be initiated, which may reduce maternal and fetal death or morbidity, as well as cardiovascular risks in women later in life.
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DOI：
10.1111/j.1471-0528.2000.tb11587.x
发表时间：
2000-01-01
期刊：
BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY
影响因子：
--
作者：
Aune, B;Vårtun, Å;Sager, G
通讯作者：
Sager, G
影响因子：
19.6
作者：
Chapman, AB;Abraham, WT;Schrier, RW
通讯作者：
Schrier, RW
影响因子：
4
作者：
Jarvis, Sara S.;Shibata, Shigeki;Fu, Qi
通讯作者：
Fu, Qi
影响因子：
2.7
作者：
Fu Q;Levine BD
通讯作者：
Levine BD
影响因子：
7.2
作者：
Caughey, AB;Stotland, NE;Escobar, GJ
通讯作者：
Escobar, GJ