Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Mayo Clinic, 200 1st Street South West, Rochester, MN, 55905, USA.
Department of Cardiovascular Medicine, Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
Curr Hypertens Rep. 2018 Jul 3;20(8):69. doi: 10.1007/s11906-018-0868-9.
Hypertensive disorders of pregnancy (HDP) often result in cardiac dysfunction and have been variably included as a risk factor for peripartum cardiomyopathy (PPCM). However, there is debate regarding the relationship between the two entities.
Diastolic dysfunction appears to be more predominant among gravidas with HDP, while systolic dysfunction predominates in PPCM. However, this finding is not consistent in all studies. Recent examinations of mortality and morbidity associated with PPCM in the setting of HDP do not demonstrate a predominant pattern with a mixture of results. Further, right ventricular dysfunction is identified to be a common theme in both populations. From a basic science perspective, there is evidence to demonstrate a predominantly anti-angiogenic milieu in both PPCM and HDP. PPCM and HDP associated cardiomyopathy overlap significantly. As such, unifying theories for their pathophysiology should be investigated.
妊娠高血压疾病(HDP)常导致心功能障碍,并被不同程度地列为围产期心肌病(PPCM)的危险因素。然而,两者之间的关系仍存在争议。
舒张功能障碍似乎在 HDP 孕妇中更为常见,而收缩功能障碍在 PPCM 中更为常见。然而,并非所有研究都得出了一致的结果。最近对 HDP 背景下 PPCM 相关死亡率和发病率的研究并未表现出一种主要模式,结果不一。此外,右心室功能障碍在这两个群体中都是一个常见的主题。从基础科学的角度来看,有证据表明 PPCM 和 HDP 中存在以抗血管生成为主的环境。PPCM 和 HDP 相关的心肌病有很大的重叠。因此,应该研究它们病理生理学的统一理论。