Physiological Remodeling of Mammalian Cardiovascular Tissues During Development and Pregnancy

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Pregnancy is accompanied by extraordinary changes in cardiovascular conditions. Blood volume is increased by ~40% and cardiac output increases by more than 50%, with more than half of that increase occurring in the first 8 weeks. These changes trigger structural remodelling in cardiovascular tissues, such as the heart and aorta, as they adapt to the increased loading conditions of pregnancy. However, approximately 10% of pregnant women suffer cardiovascular complications which can lead to unfavourable outcomes. Failure to undergo proper cardiovascular adaptations-including tissue remodelling-is associated with fetal growth restriction and preeclampsia: the two most common and serious pregnancy complications. More recent evidence has suggested that cardiovascular adaptations to pregnancy may be irreversible, augmented in subsequent pregnancies, and may increase the risk for cardiovascular disorders such as hypertension and arterial aneurysms. Despite the key role of cardiovascular adaptations to fetal and maternal health, very few studies have examined cardiovascular remodelling during pregnancy. To understand and intervene in these cardiovascular disorders of pregnancy, it is crucial to first understand the normal structural-functional adaptations made by maternal cardiovascular tissues. This study will provide the first comprehensive assessment of the intrinsic structural-mechanical changes of key cardiovascular tissues during pregnancy.