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Subclinical cardiac dysfunction after hypertensive disorders in pregnancy

妊娠期高血压疾病后的亚临床心功能不全

基本信息

批准号：
10002116
负责人：
CAREY FARQUHAR
金额：
$ 14.06万
依托单位：
UNIVERSITY OF NAIROBI
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-08-06 至 2023-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10002116
关键词：
Address Adult Africa South of the Sahara Biological Markers Blood Pressure C-reactive protein Cardiac Cardiovascular Diseases Cause of Death Cessation of life Chronic Clinical Research Development Disease Disease Outcome EFRAC Early identification Echocardiography Evaluation Exploratory/Developmental Grant for Diagnostic Cancer Imaging Female Future Heart Heart Injuries Heart failure High Risk Woman Income Inflammation Inflammatory Interleukin-1 Intervention Kenya Maternal Health Measurement Measures Mechanics Metabolic Diseases Metabolic syndrome Monitor Myocardial Myocardial Ischemia Myocardial dysfunction Outcome Patients Perinatal Populations at Risk Postpartum Period Postpartum Women Pre-Eclampsia Pregnancy Prevalence Preventive Intervention Prognostic Marker Prospective cohort study Public Health Reporting Research Research Infrastructure Risk Risk Factors Serum Stress Stroke Two-Dimensional Echocardiography Universities Washington Woman adverse outcome burden of illness cardiometabolism cardiovascular disorder risk cardiovascular risk factor end stage disease experience heart function heart imaging hemodynamics imaging biomarker immune activation inflammatory marker low and middle-income countries mortality novel outcome forecast pregnancy disorder pregnancy hypertension preservation prevent screening

项目摘要

7. ABSTRACT Cardiovascular disease (CVD) remains the leading cause of mortality globally. About three quarters of CVD deaths occur in the low- and middle-income settings. Although CVD related deaths have progressively declined in high income settings, mortality among adults below 55 years especially women have stagnated, most likely due to female specific risk factors. One such factor, new onset hypertensive disorders of pregnancy (HDP) is associated with 2-fold or greater risk for future metabolic syndrome, chronic low-grade inflammation and heart failure. However, majority of studies on long-term heart failure risk after HDP have mostly focused on end-stage disease and not the progression of asymptomatic cardiac dysfunction. Previous studies have shown that even the asymptomatic patients with myocardial dysfunction have compromised prognosis with an increased risk of developing symptomatic heart failure in the future. Therefore, early identification of at-risk population of women is critical and would allow implementation of intervention strategies to delay the progression or to prevent the onset of heart failure. Few studies in high income settings and none in SSA have evaluated the risk and correlates of subclinical cardiac dysfunction after HDP using speckle tracking echocardiography (STE) which accurately quantifies myocardial mechanics, including global longitudinal strain (GLS), a prognostic marker of adverse CVD outcomes. Using STE, we aim to understand and describe the presence and progression of asymptomatic cardiac dysfunction after pregnancies complicated with HDP (Aim 1) and evaluate the contribution of inflammation at 3 years postpartum by comparing women with and without new onset of new hypertensive disorders of pregnancy (Aims 2 and 3). The study findings will inform the development of novel and scalable screening and monitoring strategies to manage CVD risk after HDP and therefore reduce CVD and CVD- mortality in sub-Saharan Africa and globally.

7. 摘要