Near to One's Heart: The Intimate Relationship Between the Placenta and Fetal Heart.
Near to One's Heart: The Intimate Relationship Between the Placenta and Fetal Heart.
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DOI：
10.3389/fphys.2018.00629
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发表时间：
2018
影响因子：
4
通讯作者：
Sferruzzi-Perri AN
中科院分区：
文献类型：
--
作者：
Camm EJ;Botting KJ;Sferruzzi-Perri AN
胎儿心脏的发育受到多种因素的精细控制，从体液到机械力。调节这些因素的守门人是胎盘，一个外部的胎儿器官。因此，胎盘血管床内的阻力直接影响胎儿循环，从而影响发育中的心脏。此外，胎盘作为母亲和胎儿之间的界面，控制基质交换和激素释放到两个循环中。胎盘和胎心之间的复杂关系在临床胎盘病理学的情况下得到赞赏。脐带插入异常与先天性心脏缺陷有关。同样，双胎输血综合征，即单绒毛膜双胎由于双胎间血管畸形而不平等地分享胎盘，可导致两个胎儿的心脏重塑和功能障碍。此外，流行病学研究表明胎盘表型特征与成年期心血管疾病风险增加之间存在联系。迄今为止，胎盘、胎儿心脏发育和以后心功能障碍风险之间关系的机制基础尚未完全阐明。然而，在实验动物中使用环境暴露和基因操作的研究正在提供有关途径的见解。同样，大型动物母体和胎儿循环的手术器械使特定的体液和机械因素的操纵，以调查其在胎儿心脏发育中的作用。这篇综述将集中在这些研究以及迄今为止关于胎盘和心脏发育之间联系的已知内容。
The development of the fetal heart is exquisitely controlled by a multitude of factors, ranging from humoral to mechanical forces. The gatekeeper regulating many of these factors is the placenta, an external fetal organ. As such, resistance within the placental vascular bed has a direct influence on the fetal circulation and therefore, the developing heart. In addition, the placenta serves as the interface between the mother and fetus, controlling substrate exchange and release of hormones into both circulations. The intricate relationship between the placenta and fetal heart is appreciated in instances of clinical placental pathology. Abnormal umbilical cord insertion is associated with congenital heart defects. Likewise, twin-to-twin transfusion syndrome, where monochorionic twins have unequal sharing of their placenta due to inter-twin vascular anastomoses, can result in cardiac remodeling and dysfunction in both fetuses. Moreover, epidemiological studies have suggested a link between placental phenotypic traits and increased risk of cardiovascular disease in adult life. To date, the mechanistic basis of the relationships between the placenta, fetal heart development and later risk of cardiac dysfunction have not been fully elucidated. However, studies using environmental exposures and gene manipulations in experimental animals are providing insights into the pathways involved. Likewise, surgical instrumentation of the maternal and fetal circulations in large animal species has enabled the manipulation of specific humoral and mechanical factors to investigate their roles in fetal cardiac development. This review will focus on such studies and what is known to date about the link between the placenta and heart development.
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影响因子：
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作者：
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