Fetal circulation and perinatal programming

ESC CardioMed ◽  
2018 ◽  
pp. 746-748
Author(s):  
Marietta Charakida
Keyword(s):  
Congenital Heart ◽  
Structure And Function ◽  
Complex Congenital Heart Disease ◽  
Fetal Life ◽  
Perinatal Programming ◽  
Fetal Circulation ◽  
Limited Ability ◽  
In Series ◽  
And Function ◽  
Fetal Cardiac Imaging

In fetal life, the systemic and pulmonary circulations exist in parallel, rather than in series, permitting survival even in the presence of complex congenital heart disease. The fetal heart also differs in terms of its structure and function and has a limited ability to modify cardiac output. Increases in afterload are associated with marked depression in cardiac function. Much has been learnt from fetal cardiac imaging, not only for detection but also for understanding of pathophysiology and transition to the postnatal circulation.

scholarly journals Neuroplacentology in congenital heart disease: placental connections to neurodevelopmental outcomes

2021 ◽  
Author(s):  
Rachel L. Leon ◽  
Imran N. Mir ◽  
Christina L. Herrera ◽  
Kavita Sharma ◽  
Catherine Y. Spong ◽  
...  
Keyword(s):  
Brain Development ◽  
Congenital Heart ◽  
Fetal Brain ◽  
In Utero ◽  
Structure And Function ◽  
Brain Growth ◽  
Neurodevelopmental Outcomes ◽  
Fetal Brain Development ◽  
And Function

Abstract Children with congenital heart disease (CHD) are living longer due to effective medical and surgical management. However, the majority have neurodevelopmental delays or disorders. The role of the placenta in fetal brain development is unclear and is the focus of an emerging field known as neuroplacentology. In this review, we summarize neurodevelopmental outcomes in CHD and their brain imaging correlates both in utero and postnatally. We review differences in the structure and function of the placenta in pregnancies complicated by fetal CHD and introduce the concept of a placental inefficiency phenotype that occurs in severe forms of fetal CHD, characterized by a myriad of pathologies. We propose that in CHD placental dysfunction contributes to decreased fetal cerebral oxygen delivery resulting in poor brain growth, brain abnormalities, and impaired neurodevelopment. We conclude the review with key areas for future research in neuroplacentology in the fetal CHD population, including (1) differences in structure and function of the CHD placenta, (2) modifiable and nonmodifiable factors that impact the hemodynamic balance between placental and cerebral circulations, (3) interventions to improve placental function and protect brain development in utero, and (4) the role of genetic and epigenetic influences on the placenta–heart–brain connection. Impact Neuroplacentology seeks to understand placental connections to fetal brain development. In fetuses with CHD, brain growth abnormalities begin in utero. Placental microstructure as well as perfusion and function are abnormal in fetal CHD.

scholarly journals Genetic Analysis of Right Heart Structure and Function in 40,000 People

2021 ◽  
Author(s):  
James P. Pirruccello ◽  
Paolo Di Achille ◽  
Victor Nauffal ◽  
Mahan Nekoui ◽  
Samuel N. Friedman ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Deep Learning ◽  
Right Ventricular ◽  
Congenital Heart ◽  
Left Ventricular ◽  
Structure And Function ◽  
Right Heart ◽  
Heart Chamber ◽  
The Right ◽  
And Function

The heart evolved hundreds of millions of years ago. During mammalian evolution, the cardiovascular system developed with complete separation between pulmonary and systemic circulations incorporated into a single pump with chambers dedicated to each circulation. A lower pressure right heart chamber supplies deoxygenated blood to the lungs, while a high pressure left heart chamber supplies oxygenated blood to the rest of the body. Due to the complexity of morphogenic cardiac looping and septation required to form these two chambers, congenital heart diseases often involve maldevelopment of the evolutionarily recent right heart chamber. Additionally, some diseases predominantly affect structures of the right heart, including arrhythmogenic right ventricular cardiomyopathy (ARVC) and pulmonary hypertension. To gain insight into right heart structure and function, we fine-tuned deep learning models to recognize the right atrium, the right ventricle, and the pulmonary artery, and then used those models to measure right heart structures in over 40,000 individuals from the UK Biobank with magnetic resonance imaging. We found associations between these measurements and clinical disease including pulmonary hypertension and dilated cardiomyopathy. We then conducted genome-wide association studies, identifying 104 distinct loci associated with at least one right heart measurement. Several of these loci were found near genes previously linked with congenital heart disease, such as NKX2-5, TBX3, WNT9B, and GATA4. We also observed interesting commonalities and differences in association patterns at genetic loci linked with both right and left ventricular measurements. Finally, we found that a polygenic predictor of right ventricular end systolic volume was associated with incident dilated cardiomyopathy (HR 1.28 per standard deviation; P = 2.4E-10), and remained a significant predictor of disease even after accounting for a left ventricular polygenic score. Harnessing deep learning to perform large-scale cardiac phenotyping, our results yield insights into the genetic and clinical determinants of right heart structure and function.

scholarly journals Interplay of brain structure and function in neonatal congenital heart disease

2016 ◽  
Vol 3 (9) ◽  
pp. 708-722 ◽  
Author(s):  
Ala Birca ◽  
Vasily A. Vakorin ◽  
Prashob Porayette ◽  
Sujana Madathil ◽  
Vann Chau ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Brain Structure ◽  
Congenital Heart ◽  
Structure And Function ◽  
Brain Structure And Function ◽  
And Function

Cardiovascular anatomy and function imaging with the dsr in humans with complex congenital heart disease — Initial results

1982 ◽  
Vol 49 (4) ◽  
pp. 975 ◽  
Author(s):  
Lawrence J. Sinak ◽  
Eric A. Hoffman ◽  
Richard A. Robb ◽  
James H. Kinsey ◽  
Earl H. Wood ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Complex Congenital Heart Disease ◽  
And Function ◽  
Initial Results

The European Paediatric Cardiac Code Long List: structure and function — the first revision

2002 ◽  
Vol 12 (S2) ◽  
pp. 9-17 ◽  
Author(s):  
Rodney C. G. Franklin
Keyword(s):  
The Netherlands ◽  
Hierarchical Structure ◽  
Cardiac Disease ◽  
Adult Life ◽  
Structure And Function ◽  
Fetal Life ◽  
Coding System ◽  
List Structure ◽  
European Paediatric ◽  
And Function

The Long ListThe Long List is a comprehensive hierarchical system of coding and classification for the diagnosis and treatment of cardiac disease. The list was first published in 2000, as part of the standard coding system recommended by the Association for European Paediatric Cardiology for use across Europe. It embraces the entirety of the diagnosis and therapy of children with congenital and acquired cardiac disease. The Long List, as a whole, was adopted by the Association in 1998. Its development and expansion has been detailed previously. In essence, it grew from a list of 507 purely diagnostic terms published in 1985, through to a 1,777 item, hierarchical 12 tree structure in the Netherlands by 1988, and then to a single hierarchical structure of over 4,300 items in London by 1994. Although originally aimed at the clinician or surgeon treating cardiac disease first appearing in infancy or childhood, during this time it was enlarged to encompass abnormalities first diagnosed in fetal life, as well as cardiac disease first acquired during adult life. The list published in 2000 was composed of 4,777 items. These were made up of 3,906 individual terms, most of whom were mutually exclusive and unambivalent, given the constraints of clinical ambiguities and differing cultures of practice.

Perinatal programming of adult hippocampal structure and function; emerging roles of stress, nutrition and epigenetics

2013 ◽  
Vol 36 (11) ◽  
pp. 621-631 ◽  
Author(s):  
Paul J. Lucassen ◽  
Eva F.G. Naninck ◽  
Johannes B. van Goudoever ◽  
Carlos Fitzsimons ◽  
Marian Joels ◽  
...  
Keyword(s):  
Structure And Function ◽  
Perinatal Programming ◽  
And Function ◽  
Hippocampal Structure

Structure and function of neural networks in the retina

1988 ◽  
Vol 46 ◽  
pp. 26-27
Author(s):  
Peter Sterling
Keyword(s):  
Ganglion Cells ◽  
Three Dimensional ◽  
Structure And Function ◽  
Synaptic Connections ◽  
Visual Axis ◽  
One Dimensional ◽  
Cat Retina ◽  
Ultrathin Sections ◽  
And Function ◽  
Insight Into

The synaptic connections in cat retina that link photoreceptors to ganglion cells have been analyzed quantitatively. Our approach has been to prepare serial, ultrathin sections and photograph en montage at low magnification (˜2000X) in the electron microscope. Six series, 100-300 sections long, have been prepared over the last decade. They derive from different cats but always from the same region of retina, about one degree from the center of the visual axis. The material has been analyzed by reconstructing adjacent neurons in each array and then identifying systematically the synaptic connections between arrays. Most reconstructions were done manually by tracing the outlines of processes in successive sections onto acetate sheets aligned on a cartoonist's jig. The tracings were then digitized, stacked by computer, and printed with the hidden lines removed. The results have provided rather than the usual one-dimensional account of pathways, a three-dimensional account of circuits. From this has emerged insight into the functional architecture.

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