Aspirin to prevent cardiac dysfunction in preeclampsia

摘要 子痫前期是一种以高血压和多器官损害为特征的妊娠晚期疾病， 仅增加围产期发病率，但与产后心力衰竭的发展有关， 包括心肌纤维化和收缩性心力衰竭。尽管二十年的研究证明了这一点， 协会和一个大的公共卫生负担，介导的分子机制PE诱导产后 心力衰竭仍然知之甚少，且缺乏预防该结果治疗。一个潜在的触发点 可能是促纤维化生长因子激活素A，转化生长因子β家族的成员 由胎盘和炎症细胞产生。 使用阿司匹林与安慰剂治疗先兆子痫患者的随机机制临床试验， 随着对阿司匹林和激活素A可能影响心脏的机制的研究，我们将极大地 对先兆子痫的心功能障碍及其可能的治疗方法的进一步认识。我们追查两个具体的 旨在回答这些问题。AIM1是一项随机试验，旨在测试阿司匹林是否改善心脏功能 并降低先兆子痫妇女的激活素A。AIM 2可显著增加血浆激活素A水平， 怀孕导致产后心功能障碍以及阿司匹林如何预防。该项目创新 为了极大地推进我们对一个主要原因的理解， 发病率和死亡率。

ABSTRACT Preeclampsia (PE) is a disease of late pregnancy characterized by hypertension and organ damage, which not only increases peripartum morbidity but is associated with the postpartum development of heart failure, including myocardial fibrosis and systolic heart failure. Despite two decades of research demonstrating this association and a large public health burden, the molecular mechanisms mediating PE-induced postpartum heart failure remain poorly understood and therapies to prevent this outcome are lacking. One potential trigger may be the profibrotic growth factor Activin A, a member of the transforming growth factor beta family produced by the placenta and inflammatory cells. Using a randomized mechanistic clinical trial of aspirin vs. placebo for patients with preeclampsia, integrated with studies of the mechanisms by which aspirin and Activin A might affect the heart, we will dramatically advance knowledge of cardiac dysfunction in preeclampsia and its possible treatments. We pursue two specific aims to answer these questions. AIM 1 is a randomized trial to test whether aspirin improves cardiac function and decreases Activin A in women with preeclampsia. AIM 2 Identifies how increased plasma Activin A during pregnancy causes postpartum cardiac dysfunction and how aspirin prevents it. This project innovates methodologically and at the bench in order to dramatically advance our understanding of a major cause of morbidity and mortality in women globally.