The Ritchie Centre, Hudson Institute of Medical Research, Clayton, Victoria, Australia.
Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia.
Am J Physiol Heart Circ Physiol. 2023 Dec 1;325(6):H1266-H1278. doi: 10.1152/ajpheart.00495.2023. Epub 2023 Sep 29.
Fetal growth restriction (FGR) increases the risk cardiovascular disease (CVD) in adulthood. Placental insufficiency and subsequent chronic fetal hypoxemia are causal factors for FGR, leading to a redistribution of blood flow that prioritizes vital organs. Subclinical signs of cardiovascular dysfunction are evident in growth-restricted neonates; however, the mechanisms programming for CVD in adulthood remain unknown. This study aimed to determine the potential mechanisms underlying structural and functional changes within the heart and essential (carotid) and nonessential (femoral) vascular beds in growth-restricted lambs. Placental insufficiency was surgically induced in ewes at 89 days gestational age (dGA, term = 148dGA). Three age groups were investigated: fetal (126dGA), newborn (24 h after preterm birth), and 4-wk-old lambs. In vivo and histological assessments of cardiovascular indices were undertaken. Resistance femoral artery function was assessed via in vitro wire myography and blockade of key vasoactive pathways including nitric oxide, prostanoids, and endothelium-dependent hyperpolarization. All lambs were normotensive throughout the first 4 wk of life. Overall, the FGR cohort had more globular hearts compared with controls ( = 0.0374). A progressive decline in endothelium-dependent vasodilation was demonstrated in FGR lambs compared with controls. Further investigation revealed that impairment of the prostanoid pathway may drive this reduction in vasodilatory capacity. Clinical indicators of CVD were not observed in our FGR lambs. However, subclinical signs of cardiovascular dysfunction were present in our FGR offspring. This study provides insight into potential mechanisms, such as the prostanoid pathway, that may warrant therapeutic interventions to improve cardiovascular development in growth-restricted newborns. Our findings provide novel insight into the potential mechanisms that program for cardiovascular dysfunction in growth-restricted neonates as our growth-restricted lambs exhibited a progressive decline in endothelium-dependent vasodilation in the femoral artery between birth and 4 wk of age. Subsequent analyses indicated that this reduction in vasodilatory capacity is likely to be mediated by the prostanoid pathway and prostanoids could be a potential target for therapeutic interventions for fetal growth restriction (FGR).
胎儿生长受限(FGR)增加了成年后患心血管疾病(CVD)的风险。胎盘功能不全和随后的慢性胎儿低氧血症是 FGR 的因果因素,导致血流重新分配,优先供应重要器官。生长受限的新生儿有明显的心血管功能障碍亚临床征象;然而,成年后患 CVD 的编程机制尚不清楚。本研究旨在确定在生长受限羔羊的心脏和基本(颈动脉)和非基本(股动脉)血管床内结构和功能变化的潜在机制。在妊娠 89 天时(足月= 148 天)对母羊进行手术诱导胎盘功能不全。研究了三个年龄组:胎儿(126 天)、新生儿(早产 24 小时后)和 4 周龄羔羊。进行了心血管指数的体内和组织学评估。通过体外电生理和血管张力测定法评估股动脉功能,阻断关键的血管活性途径,包括一氧化氮、前列腺素和内皮依赖性超极化。所有羔羊在生命的前 4 周内血压均正常。总的来说,与对照组相比,FGR 组的心脏更呈球形(= 0.0374)。与对照组相比,FGR 羔羊的内皮依赖性血管舒张逐渐下降。进一步的研究表明,前列腺素途径的损伤可能导致这种血管舒张能力的降低。我们的 FGR 羔羊没有观察到 CVD 的临床指标。然而,我们的 FGR 后代存在心血管功能障碍的亚临床征象。本研究提供了潜在机制的见解,如前列腺素途径,这可能需要治疗干预来改善生长受限新生儿的心血管发育。我们的发现为潜在机制提供了新的见解,这些机制可能会导致生长受限新生儿的心血管功能障碍,因为我们的生长受限羔羊在出生至 4 周龄之间股动脉的内皮依赖性血管舒张逐渐下降。随后的分析表明,这种血管舒张能力的降低可能是由前列腺素途径介导的,前列腺素可能是胎儿生长受限(FGR)治疗干预的潜在靶点。