scholarly journals Acute Atherosis Lesions at the Fetal-Maternal Border: Current Knowledge and Implications for Maternal Cardiovascular Health

2021 ◽  
Vol 12 ◽  
Author(s):  
Daniel Pitz Jacobsen ◽  
Heidi Elisabeth Fjeldstad ◽  
Guro Mørk Johnsen ◽  
Ingrid Knutsdotter Fosheim ◽  
Kjartan Moe ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Current Knowledge ◽  
Ischemia Reperfusion ◽  
Spiral Artery ◽  
Vacuum Suction ◽  
Decidua Basalis ◽  
Premature Cardiovascular Disease ◽  
Increased Risk ◽  
Fetal Microchimerism ◽  
Acute Atherosis

Decidua basalis, the endometrium of pregnancy, is an important interface between maternal and fetal tissues, made up of both maternal and fetal cells. Acute atherosis is a uteroplacental spiral artery lesion. These patchy arterial wall lesions containing foam cells are predominantly found in the decidua basalis, at the tips of the maternal arteries, where they feed into the placental intervillous space. Acute atherosis is prevalent in preeclampsia and other obstetric syndromes such as fetal growth restriction. Causal factors and effects of acute atherosis remain uncertain. This is in part because decidua basalis is challenging to sample systematically and in large amounts following delivery. We summarize our decidua basalis vacuum suction method, which facilitates tissue-based studies of acute atherosis. We also describe our evidence-based research definition of acute atherosis. Here, we comprehensively review the existing literature on acute atherosis, its underlying mechanisms and possible short- and long-term effects. We propose that multiple pathways leading to decidual vascular inflammation may promote acute atherosis formation, with or without poor spiral artery remodeling and/or preeclampsia. These include maternal alloreactivity, ischemia-reperfusion injury, preexisting systemic inflammation, and microbial infection. The concept of acute atherosis as an inflammatory lesion is not novel. The lesions themselves have an inflammatory phenotype and resemble other arterial lesions of more extensively studied etiology. We discuss findings of concurrently dysregulated proteins involved in immune regulation and cardiovascular function in women with acute atherosis. We also propose a novel hypothesis linking cellular fetal microchimerism, which is prevalent in women with preeclampsia, with acute atherosis in pregnancy and future cardiovascular and neurovascular disease. Finally, women with a history of preeclampsia have an increased risk of premature cardiovascular disease. We review whether presence of acute atherosis may identify women at especially high risk for premature cardiovascular disease.

scholarly journals Acute atherosis in vacuum suction biopsies of decidua basalis: An evidence based research definition

Placenta ◽  
2016 ◽  
Vol 37 ◽  
pp. 26-33 ◽  
Author(s):  
Patji Alnaes-Katjavivi ◽  
Fiona Lyall ◽  
Borghild Roald ◽  
Christopher W.G. Redman ◽  
Anne Cathrine Staff
Keyword(s):  
Evidence Based ◽  
Vacuum Suction ◽  
Decidua Basalis ◽  
Acute Atherosis

Hypertension

2012 ◽  
Author(s):  
Gary L. Schwartz
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Diastolic Pressure ◽  
Systolic Pressure ◽  
Normal Pressure ◽  
Premature Cardiovascular Disease ◽  
Increased Risk ◽  
Treatment Of Hypertension ◽  
Definition Of ◽  
Over Time

Because blood pressure is a continuously distributed trait in the population and the risk of cardiovascular disease associated with the level of pressure increases progressively as it exceeds 115 mm Hg systolic or 75 mm Hg diastolic, the definition of hypertension is somewhat arbitrary. Currently for adults, it is defined as systolic pressure 140 mm Hg or higher or diastolic pressure 90 mm Hg or higher. Systolic pressures between 120 and 139 mm Hg or diastolic pressures between 80 and 89 mm Hg are classified as prehypertension. Persons who have prehypertension are at increased risk of premature cardiovascular disease and progression to hypertension over time compared with persons who have normal pressure. Epidemiology, diagnosis, and treatment of hypertension are also reviewed.

scholarly journals Assessing knowledge of healthcare providers concerning cardiovascular risk after hypertensive disorders of pregnancy: an Australian national survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Heike Roth ◽  
Caroline S. E. Homer ◽  
Clare Arnott ◽  
Lynne Roberts ◽  
Mark Brown ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Cardiovascular Health ◽  
Gestational Hypertension ◽  
Current Knowledge ◽  
Healthcare Providers ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Increased Risk

Abstract Background Hypertensive disorders of pregnancy (HDP) affect 5–10% of pregnant women. Women after HDP have 2–3 times increased risk of heart attack, stroke and diabetes, as soon as 5–10 years after pregnancy. Australian healthcare providers’ knowledge of cardiovascular disease (CVD) risks for women after HDP is unknown, and this study aimed to explore their current knowledge and practice regarding long-term cardiovascular health after HDP, as a precursor to producing targeted healthcare provider education on health after HDP. Methods A custom-created, face-validated online survey explored knowledge about long-term risks after HDP. Distribution occurred from February to July 2019 via professional colleges, key organisations and social media. The objective was to assess current knowledge and knowledge gaps amongst a group of healthcare providers (HCP) in Australia, regarding long-term cardiovascular health after hypertensive disorders of pregnancy (HDP), specifically gestational hypertension or preeclampsia. Results Of 492 respondents, 203 were midwives, 188 obstetricians, 75 general practitioners (GP), and 26 cardiologists. A risk knowledge score was computed with 0–6 considered low, 6.1–8.9 moderate and 9–12 high. Most participants (85%) were aware of increased cardiovascular disease after preeclampsia and gestational hypertension (range 76% midwives to 100% cardiologists). There were significant differences in average knowledge scores regarding health after preeclampsia; high for cardiologists (9.3), moderate for GPs and obstetricians (8.2 and 7.6 respectively) and low for midwives (5.9). Average knowledge scores were somewhat lower for gestational hypertension (9.0 for cardiologists, 7.4 for obstetricians and GPs, 5.1 for midwives). Knowledge was highest regarding risk of chronic hypertension, moderate to high regarding risk of ischaemic heart disease, stroke and recurring HDP, and low for diabetes and peripheral vascular disease. Only 34% were aware that risks start < 10 years after the affected pregnancy. Conclusion(s) Participants were aware there is increased cardiovascular risk after HDP, although less aware of risks after gestational hypertension and some specific risks including diabetes. Findings will inform the development of targeted education.

Corrigendum to “Acute atherosis in vacuum suction biopsies of decidua basalis: An evidence based research definition” [Placenta 37C (2016) 26–33]

Placenta ◽  
2017 ◽  
Vol 52 ◽  
pp. 114-115
Author(s):  
Patji Alnaes-Katjavivi ◽  
Fiona Lyall ◽  
Borghild Roald ◽  
Christopher W.G. Redman ◽  
Anne Cathrine Staff
Keyword(s):  
Evidence Based ◽  
Vacuum Suction ◽  
Decidua Basalis ◽  
Acute Atherosis

scholarly journals S100A8 and S100A9: DAMPs at the Crossroads between Innate Immunity, Traditional Risk Factors, and Cardiovascular Disease

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Alexandru Schiopu ◽  
Ovidiu S. Cotoi
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Inflammatory Responses ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Increased Risk ◽  
Coronary Events ◽  
Traditional Risk Factors ◽  
Myocardial Ischemia Reperfusion

Amplification of innate immune responses by endogenous danger-associated molecular patterns (DAMPs) promotes inflammation. The involvement of S100A8 and S100A9, DAMPs belonging to the S100 calgranulin family, in the pathogenesis of cardiovascular disease is attracting an increasing amount of interest. S100A8 and S100A9 (also termed MRP8 and MRP14) preferentially form the S100A8/A9 heterodimer (MRP8/14 or calprotectin) and are constitutively expressed in myeloid cells. The levels of circulating S100A8/A9 in humans strongly correlate to blood neutrophil counts and are increased by traditional cardiovascular risk factors such as smoking, obesity, hyperglycemia, and dyslipidemia. S100A8/A9 is an endogenous ligand of toll-like receptor 4 (TLR4) and of the receptor for advanced glycation end products (RAGE) and has been shown to promote atherogenesis in mice. In humans, S100A8/A9 correlates with the extent of coronary and carotid atherosclerosis and with a vulnerable plaque phenotype. S100A8/A9 is locally released following myocardial infarction and amplifies the inflammatory responses associated with myocardial ischemia/reperfusion injury. Elevated plasma levels of S100A8/A9 are associated with increased risk of future coronary events in healthy individuals and in myocardial infarction survivors. Thus, S100A8/A9 might represent a useful biomarker and therapeutic target in cardiovascular disease. Importantly, S100A8/A9 blockers have been developed and are approved for clinical testing.

scholarly journals Development and Internal Validation of a Model Predicting Premature Cardiovascular Disease Among Women With Hypertensive Disorders of Pregnancy: A Population‐Based Study in Quebec, Canada

2020 ◽  
Vol 9 (20) ◽  
Author(s):  
U. Vivian Ukah ◽  
Natalie Dayan ◽  
Nathalie Auger ◽  
Siyi He ◽  
Robert W. Platt
Keyword(s):  
Cardiovascular Disease ◽  
Risk Stratification ◽  
Prediction Models ◽  
External Validation ◽  
Population Based ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Premature Cardiovascular Disease ◽  
Increased Risk

Background Hypertensive disorders of pregnancy (HDP) are associated with an increased risk of premature cardiovascular disease (CVD), but existing cardiovascular prediction models do not adequately capture risks in young women. We developed a model to predict the 10‐year risk of premature CVD and mortality among women who have HDP. Methods and Results Using a population‐based cohort of women with HDP who delivered between April 1989 and March 2017 in Quebec, Canada, we developed a 10‐year CVD risk model using Cox proportional hazards regression. Women aged 18 to 45 years were followed from their first HDP‐complicated delivery until March 2018. We assessed performance of the model based on discrimination, calibration, and risk stratification ability. Internal validity was assessed using the bootstrap method. The cohort included 95 537 women who contributed 1 401 084 person‐years follow‐up. In total, 4024 (4.2%) of women were hospitalized for CVD, of which 1585 events (1.6%) occurred within 10 years of follow‐up. The final model had modest discriminatory performance (area under the receiver operating characteristic curve, 0.66; 95% CI, 0.65–0.67) and good calibration with slope of 0.95 and intercept of −0.19. There was moderate classification accuracy (likelihood ratio+: 5.90; 95% CI, 5.01–6.95) in the highest‐risk group upon risk stratification. Conclusions Overall, our model had modest performance in predicting the 10‐year risk of premature CVD for women with HDP. We recommend the addition of clinical variables, and external validation, before consideration for clinical use.

scholarly journals Kidney Ischemia-Reperfusion Decreases Hydrogen Sulfide and Increases Oxidative Stress in the Heart

Biomolecules ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 1565
Author(s):  
Charith U. B. Wijerathne ◽  
Susara Madduma Hewage ◽  
Yaw L. Siow ◽  
Karmin O
Keyword(s):  
Oxidative Stress ◽  
Cardiovascular Disease ◽  
Hydrogen Sulfide ◽  
Ischemia Reperfusion ◽  
Kidney Injury ◽  
Underlying Mechanism ◽  
Sprague Dawley ◽  
Increased Risk ◽  
H2s Production ◽  
Kidney Ischemia

Patients with acute kidney injury (AKI) have an increased risk of cardiovascular disease. The underlying mechanism of AKI-induced heart injury is not well-understood. Hydrogen sulfide (H2S), at physiological concentrations, has been implicated in cardiovascular protection through redox balance and vessel relaxation. Cystathionine gamma-lyase (CSE) plays an essential role in H2S production in the heart. The present study investigated the effect of AKI on H2S production and oxidative stress in the heart. AKI was induced by kidney ischemia-reperfusion in male and female Sprague-Dawley rats, which led to an increase in plasma creatinine and blood urea nitrogen levels. There was a significant increase in lipid peroxidation and a decrease in glutathione (antioxidant) levels in the plasma and heart, indicating systemic and cardiac oxidative stress. Kidney ischemia-reperfusion reduced CSE expression and H2S production in the heart. There was a decrease in antioxidant transcription factor Nrf2 level in the nucleus and an increase in inflammatory cytokine (IL-6, TNF-α) expression in the heart. These results suggest that AKI can down-regulate CSE-mediated H2S production, reduce glutathione levels and increase oxidative stress in the heart. This may contribute to an increased risk of cardiovascular disease in AKI.

scholarly journals Blood Pressure Tracking From Childhood to Adulthood

2021 ◽  
Vol 9 ◽  
Author(s):  
Tatsuhiko Azegami ◽  
Keiko Uchida ◽  
Mitsuaki Tokumura ◽  
Masaaki Mori
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Lifestyle Modification ◽  
Communicable Disease ◽  
Blood Pressure Monitoring ◽  
Positive Association ◽  
Monitoring And Control ◽  
Premature Cardiovascular Disease ◽  
Increased Risk ◽  
Global Health Issue

Hypertension is the most common non-communicable disease among adults and is the most important modifiable risk factor for premature cardiovascular disease. The increasing worldwide burden of hypertension is a major global health issue. Early prevention with lifestyle modification or pharmaceutical treatment reduces the incidence of hypertension and the risk of subsequent cardiovascular disease. Therefore, identification of young persons at risk for hypertension has the obvious benefit of providing a chance for early intervention. Previous studies have demonstrated the positive association of elevated childhood blood pressure with hypertension in adulthood. Accumulated evidence also indicates the possibility that elevated pediatric blood pressure is associated with increased risk of future cardiovascular disease. In this article, we review the tracking of blood pressure from childhood to adulthood and emphasize the importance of pediatric blood pressure monitoring and control for predicting and preventing adult hypertension and cardiovascular disease.

scholarly journals Cardiovascular Risk Factors and Screening Modalities in Firefighters

2020 ◽  
pp. 38-40
Author(s):  
Kyle Smith ◽  
David D’agate
Keyword(s):  
Cardiovascular Disease ◽  
Well Being ◽  
The United States ◽  
Premature Cardiovascular Disease ◽  
Novel Approach ◽  
Increased Risk ◽  
The Family ◽  
Public Risk ◽  
Health And Well Being ◽  
Medical Morbidity

Within the field of primary care, preventative medicine represents a novel approach to medical care that promotes health and well-being while simultaneously attempting to prevent disease, disability and death. Cardiovascular disease is one of the leading causes of medical morbidity and mortality in the United States. Certain lifestyle factors have been linked to increased risk of cardiovascular disease and, as such, are topics of focus for the prevention of cardiovascular disease. Various studies show that firefighters have an increased risk for premature cardiovascular disease compared to the general public. Risk assessment remains a paramount focus for the family physician so screening modalities are needed that accurately depict each patient’s risk without performing unnecessary testing. Specific testing modalities that should be considered are coronary artery calcium scoring, carotid artery ultrasound and EKG assessment.

Systemic lupus erythematosus and the risk of cardiovascular disease

2021 ◽  
pp. 162-164
Author(s):  
Karen Schreiber ◽  
Søren Jacobsen
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Cardiovascular Disease ◽  
Patient Group ◽  
Lupus Erythematosus ◽  
Childbearing Age ◽  
Systemic Lupus ◽  
Previous Pregnancy ◽  
Premature Cardiovascular Disease ◽  
Increased Risk ◽  
History Of

Women account for roughly 90% of patients with systemic lupus erythematosus (SLE) and they are typically diagnosed when they are in their childbearing age. Patients with SLE are at increased risk of premature cardiovascular disease (CVD) representing the major cause of morbidity and mortality in this patient group. Premature CVD is significantly pronounced in women with SLE who have a history of pre-eclampsia compared to those who have no history of pre-eclampsia. Therefore, the prevention of future CVD is particularly important in women with a previous pregnancy history complicated by pre-eclampsia. Patients worry about the possible risk for future CVD.

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