Angiogenic Imbalance and Residual Myocardial Injury in Recovered Peripartum Cardiomyopathy Patients
Angiogenic Imbalance and Residual Myocardial Injury in Recovered Peripartum Cardiomyopathy Patients
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DOI：
10.1161/circheartfailure.116.003349
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发表时间：
2016-11-01
影响因子：
9.7
通讯作者：
George, Jacob
中科院分区：
文献类型：
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作者：
Goland, Sorel;Weinstein, Jean Marc;George, Jacob
背景-最近的研究表明，妊娠期血管生成失衡可能导致急性围产期心肌病（PPCM）。我们提出，血管生成不平衡和残余的心脏功能障碍可能存在，即使从PPCM.Methods和结果，29名妇女至少12个月后，介绍与PPCM，谁表现出恢复左心室（LV）射血分数（>= 50%），包括在研究中（平均年龄35 +/-6岁，LV射血分数61.0 +/-3.9%）。测定循环内皮祖细胞（EPCs）的数量和促血管生成血管内皮生长因子和可溶性血管内皮生长因子受体Flt 1（sFlt 1）的血浆水平。所有患者均接受全面的心功能评估，包括组织多普勒成像和二维（2D）应变超声心动图。所有测量结果均与健康对照组进行比较。有PPCM病史的患者sFlt 1浓度显著较高（中位数[第25 - 75百分位数]; 149.57，[63.14-177.89] vs 20.29，[15.00-53.89] pg/mL，P
Background-Recent studies suggest that angiogenic imbalance during pregnancy may lead to acute peripartum cardiomyopathy (PPCM). We propose that angiogenic imbalance and residual cardiac dysfunction may exist even after recovery from PPCM.Methods and Results-Twenty-nine women at least 12 months after presentation with PPCM, who exhibited recovery of left ventricular (LV) ejection fraction (>= 50%), were included in the study (mean age 35 +/- 6 years, LV ejection fraction 61.0 +/- 3.9%). The number of circulating endothelial progenitor cells (EPCs) and plasma levels of proangiogenic vascular endothelial growth factor and of soluble vascular endothelial growth factor receptor Flt1 (sFlt1) were measured. All patients underwent comprehensive cardiac function assessment, including tissue Doppler imaging and 2-dimensional (2D) strain echocardiography. All measurements were compared with healthy controls. Patients with a history of PPCM have significantly higher sFlt1 concentrations (median [25th-75th percentile]; 149.57, [63.14-177.89] versus 20.29, [15.00-53.89] pg/mL, P