Cardiac Remodeling During Pregnancy With Metabolic Syndrome: Prologue of Pathological Remodeling.
Cardiac Remodeling During Pregnancy With Metabolic Syndrome: Prologue of Pathological Remodeling.
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妊娠期代谢综合征患者的心脏重构：病理重构的序幕。
DOI：
10.1161/circulationaha.120.051264
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发表时间：
2021-02-16
期刊：
影响因子：
37.8
通讯作者：
Houser SR
中科院分区：
文献类型：
--
作者：
Yang Y;Kurian J;Schena G;Johnson J;Kubo H;Travers JG;Kang C;Lucchese AM;Eaton DM;Lv M;Li N;Leynes LG;Yu D;Yang F;McKinsey TA;Kishore R;Khan M;Mohsin S;Houser SR
健康个体在怀孕期间心脏经历生理性肥大。代谢综合征（MetS）现在在育龄妇女中很普遍，可能会增加怀孕期间不良心血管事件的风险。目前的研究询问是否心脏重塑在妊娠期肥胖的个体与代谢综合征是异常的，这是否使他们更容易患心血管疾病的风险？MetS在妊娠期间诱导病理性心脏重塑的想法在长期（15周）西方饮食（WD）喂养动物模型中进行了研究，该模型概括了人类MetS的特征。将WD（45%千卡脂肪）诱导MetS的妊娠雌性小鼠与喂食对照饮食（10%千卡脂肪，CD）的妊娠和非妊娠雌性小鼠进行比较。喂食WD的怀孕小鼠心脏质量增加，并表现出病理性肥大的关键特征，包括纤维化和与病理性肥大相关的胎儿基因上调。妊娠动物的心脏与WD诱导的MetS有一个独特的基因表达谱，可能是其病理重塑的基础。同时，妊娠雌性小鼠与MetS表现出更严重的心脏肥大和恶化的心功能不全时，挑战与血管紧张素II/苯肾上腺素输注后交付。这些结果表明，预先存在的代谢综合征可能会破坏妊娠期间的生理性肥大，产生病理性心脏重塑，可能使心脏易患慢性疾病。妊娠期既存代谢综合征诱导病理性心脏重构。
The heart undergoes physiological hypertrophy during pregnancy in healthy individuals. Metabolic syndrome (MetS) is now prevalent in women of child-bearing age and might add risks of adverse cardiovascular events during pregnancy. The present study asks if cardiac remodeling during pregnancy in obese individuals with MetS is abnormal and does this predispose them to higher risk for cardiovascular disorders? The idea that MetS induces pathological cardiac remodeling during pregnancy was studied in a long-term (15 weeks) Western diet (WD) feeding animal model that recapitulated features of human MetS. Pregnant female mice with WD (45% kcal fat)-induced MetS were compared to pregnant and nonpregnant females fed a control diet (10% kcal fat, CD). Pregnant mice fed a WD had increased heart mass and exhibited key features of pathological hypertrophy, including fibrosis and upregulation of fetal genes associated with pathological hypertrophy. Hearts from pregnant animals with WD-induced MetS had a distinct gene expression profile that could underlie their pathological remodeling. Concurrently, pregnant female mice with MetS showed more severe cardiac hypertrophy and exacerbated cardiac dysfunction when challenged with angiotensin II/phenylephrine infusion after delivery. These results suggest that preexisting MetS could disrupt physiological hypertrophy during pregnancy to produce pathological cardiac remodeling that could predispose the heart to chronic disorders. Preexisting metabolic syndrome induces pathological cardiac remodeling during pregnancy.