Li Jingyuan, Umar Soban, Amjedi Marjan, Iorga Andrea, Sharma Salil, Nadadur Rangarajan D, Regitz-Zagrosek Vera, Eghbali Mansoureh
Am J Cardiovasc Dis. 2012;2(3):192-207. Epub 2012 Jul 25.
During Pregnancy, heart develops physiological left ventricular hypertrophy as a result of the natural volume overload. Previously we have characterized the molecular and functional signature of heart hypertrophy during pregnancy. Cardiac hypertrophy during pregnancy is a complex process that involves many changes including in the signalling pathways, composition of extracellular matrix as well as the levels of sex hormones. This review summarises the recent advances and the new frontiers in the context of heart hypertrophy during pregnancy. In particular we focus on structural and extracellular matrix remodelling as well as signalling pathways in pregnancy-induced physiological heart hypertrophy. Emerging evidence shows that various microRNAs modulate key components of hypertrophy, therefore the role of microRNAs in the regulation of gene expression in pregnancy induced hypertrophy is also discussed. We also review the role of ubiquitin proteasome system, the major machinery for the degradation of damaged and misfolded proteins, in heart hypertrophy. The role of sex hormones in particular estrogen in cardiac remodeling during pregnancy is also discussed. We also review pregnancy-induced cardiovascular complications such as peripartum cardiomyopathy and pre-eclampsia and how the knowledge from the animal studies may help us to develop new therapeutic strategies for better treatment of cardiovascular diseases during pregnancy. Special emphasis has to be given to the guidelines on disease management in pregnancy.
在孕期，由于自然容量超负荷，心脏会发生生理性左心室肥厚。此前我们已对孕期心脏肥厚的分子和功能特征进行了描述。孕期心脏肥厚是一个复杂的过程，涉及许多变化，包括信号通路、细胞外基质组成以及性激素水平的改变。本综述总结了孕期心脏肥厚方面的最新进展和新领域。特别关注孕期生理性心脏肥厚中的结构和细胞外基质重塑以及信号通路。新出现的证据表明，多种微小RNA调节肥厚的关键成分，因此也讨论了微小RNA在孕期诱导的肥厚中基因表达调控中的作用。我们还综述了泛素蛋白酶体系统（受损和错误折叠蛋白降解的主要机制）在心脏肥厚中的作用。还讨论了性激素尤其是雌激素在孕期心脏重塑中的作用。我们还综述了孕期诱导的心血管并发症，如围产期心肌病和子痫前期，以及动物研究中的知识如何帮助我们开发新的治疗策略，以更好地治疗孕期心血管疾病。必须特别强调孕期疾病管理指南。
