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。摘要心血管疾病（CVD）仍然是全球死亡率的主要原因。大约四分之三的CVD 在低收入和中等收入环境中死亡。尽管与CVD相关的死亡逐渐下降在高收入环境中，55岁以下的成年人的死亡率尤其是女性停滞，很可能由于女性特定的危险因素。一个这样的因素，新的发作性高血压妊娠（HDP）是与未来代谢综合征，慢性低度炎症和心脏的2倍或更大的风险相关失败。但是，大多数关于HDP后长期心力衰竭风险的研究主要集中在终点阶段疾病而不是无症状心脏功能障碍的进展。以前的研究表明，即使心肌功能障碍的无症状患者的预后损害未来发展有症状的心力衰竭。因此，早期识别高危妇女的人口是至关重要的，将允许实施干预策略，以延迟进展或防止心力衰竭的发作。在高收入环境中很少有研究，而在SSA中也没有研究风险和 HDP后使用Speckle Tracking Echcartiographic（Ste）的亚临床心脏功能障碍的相关性准确量化心肌力学，包括全球纵向应变（GLS），这是预后标记不利的CVD结果。使用Ste，我们旨在了解和描述怀孕后无症状的心脏功能障碍与HDP复杂（AIM 1）并评估贡献通过比较有或没有新的高血压发作的妇女，产后3年的炎症怀孕疾病（目标2和3）。研究结果将为新颖而可扩展的发展提供信息筛选和监视HDP后管理CVD风险的策略，因此减少CVD和CVD- 撒哈拉以南非洲和全球的死亡率。