Vargas Ana I, Tarraf Samar A, Fitzgibbons Timothy P, Bellini Chiara, Amini Rouzbeh
Department of Bioengineering, Northeastern University, Boston, MA, 02115, United States.
Department of Medicine, Division of Cardiovascular Medicine, University of Massachusetts Medical School, Worcester, MA, 01655, United States.
Curr Res Physiol. 2023 Jul 18;6:100102. doi: 10.1016/j.crphys.2023.100102. eCollection 2023.
With the rise in maternal mortality rates and the growing body of epidemiological evidence linking pregnancy history to maternal cardiovascular health, it is essential to comprehend the vascular remodeling that occurs during gestation. The maternal body undergoes significant hemodynamic alterations which are believed to induce structural remodeling of the cardiovascular system. Yet, the effects of pregnancy on vascular structure and function have not been fully elucidated. Such a knowledge gap has limited our understanding of the etiology of pregnancy-induced cardiovascular disease. Towards bridging this gap, we measured the biaxial mechanical response of the murine descending thoracic aorta during a normotensive late-gestation pregnancy. Non-invasive hemodynamic measurements confirmed a 50% increase in cardiac output in the pregnant group, with no changes in peripheral blood pressure. Pregnancy was associated with significant wall thickening ( ∼14%), an increase in luminal diameter ( ∼6%), and material softening in both circumferential and axial directions. This expansive remodeling of the tissue resulted in a reduction in tensile wall stress and intrinsic tissue stiffness. Collectively, our data indicate that an increase in the geometry of the vessel may occur to accommodate for the increase in cardiac output and blood flow that occurs in pregnancy. Similarly, wall thickening accompanied by increased luminal diameter, without a change in blood pressure may be a necessary mechanism to decrease the tensile wall stress, and avoid pathophysiological events following late gestation.
随着孕产妇死亡率的上升以及越来越多的流行病学证据将妊娠史与孕产妇心血管健康联系起来,了解妊娠期发生的血管重塑至关重要。母体身体会经历显著的血流动力学改变,据信这会引发心血管系统的结构重塑。然而,妊娠对血管结构和功能的影响尚未完全阐明。这样的知识空白限制了我们对妊娠相关心血管疾病病因的理解。为了弥合这一差距,我们测量了正常血压晚期妊娠小鼠降主动脉的双轴力学反应。非侵入性血流动力学测量证实,妊娠组的心输出量增加了50%,外周血压无变化。妊娠与显著的管壁增厚(约14%)、管腔直径增加(约6%)以及周向和轴向的材料软化有关。这种组织的扩张性重塑导致管壁拉伸应力和固有组织刚度降低。总体而言,我们的数据表明,血管几何形状的增加可能是为了适应妊娠期间心输出量和血流量的增加。同样,管壁增厚伴随着管腔直径增加,而血压不变,这可能是降低管壁拉伸应力并避免晚期妊娠后病理生理事件的必要机制。