scholarly journals Defective Uteroplacental Vascular Remodeling in Preeclampsia: Key Molecular Factors Leading to Long Term Cardiovascular Disease

2021 ◽  
Vol 22 (20) ◽  
pp. 11202
Author(s):  
Kirim Hong ◽  
Soo Hyun Kim ◽  
Dong Hyun Cha ◽  
Hee Jin Park
Keyword(s):  
Cardiovascular Disease ◽  
Vascular Remodeling ◽  
Cardiovascular Health ◽  
Current Knowledge ◽  
Management Strategies ◽  
Obstetric Outcomes ◽  
Hypertensive Disorder ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic

Preeclampsia is a complex hypertensive disorder in pregnancy which can be lethal and is responsible for more than 70,000 maternal deaths worldwide every year. Besides the higher risk of unfavorable obstetric outcomes in women with preeclampsia, another crucial aspect that needs to be considered is the association between preeclampsia and the postpartum cardiovascular health of the mother. Currently, preeclampsia is classified as one of the major risk factors of cardiovascular disease (CVD) in women, which doubles the risk of venous thromboembolic events, stroke, and ischemic heart disease. In order to comprehend the pathophysiology behind the linkage between preeclampsia and the development of postpartum CVD, a thorough understanding of the abnormal uteroplacental vascular remodeling in preeclampsia is essential. Therefore, this review aims to summarize the current knowledge of the defective process of spiral artery remodeling in preeclampsia and how the resulting placental damage leads to excessive angiogenic imbalance and systemic inflammation in long term CVD. Key molecular factors in the pathway—including novel findings of microRNAs—will be discussed with suggestions of future management strategies of preventing CVD in women with a history of preeclampsia.

scholarly journals Assessing knowledge of healthcare providers concerning cardiovascular risk after hypertensive disorders of pregnancy: an Australian national survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Heike Roth ◽  
Caroline S. E. Homer ◽  
Clare Arnott ◽  
Lynne Roberts ◽  
Mark Brown ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Cardiovascular Health ◽  
Gestational Hypertension ◽  
Current Knowledge ◽  
Healthcare Providers ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Increased Risk

Abstract Background Hypertensive disorders of pregnancy (HDP) affect 5–10% of pregnant women. Women after HDP have 2–3 times increased risk of heart attack, stroke and diabetes, as soon as 5–10 years after pregnancy. Australian healthcare providers’ knowledge of cardiovascular disease (CVD) risks for women after HDP is unknown, and this study aimed to explore their current knowledge and practice regarding long-term cardiovascular health after HDP, as a precursor to producing targeted healthcare provider education on health after HDP. Methods A custom-created, face-validated online survey explored knowledge about long-term risks after HDP. Distribution occurred from February to July 2019 via professional colleges, key organisations and social media. The objective was to assess current knowledge and knowledge gaps amongst a group of healthcare providers (HCP) in Australia, regarding long-term cardiovascular health after hypertensive disorders of pregnancy (HDP), specifically gestational hypertension or preeclampsia. Results Of 492 respondents, 203 were midwives, 188 obstetricians, 75 general practitioners (GP), and 26 cardiologists. A risk knowledge score was computed with 0–6 considered low, 6.1–8.9 moderate and 9–12 high. Most participants (85%) were aware of increased cardiovascular disease after preeclampsia and gestational hypertension (range 76% midwives to 100% cardiologists). There were significant differences in average knowledge scores regarding health after preeclampsia; high for cardiologists (9.3), moderate for GPs and obstetricians (8.2 and 7.6 respectively) and low for midwives (5.9). Average knowledge scores were somewhat lower for gestational hypertension (9.0 for cardiologists, 7.4 for obstetricians and GPs, 5.1 for midwives). Knowledge was highest regarding risk of chronic hypertension, moderate to high regarding risk of ischaemic heart disease, stroke and recurring HDP, and low for diabetes and peripheral vascular disease. Only 34% were aware that risks start < 10 years after the affected pregnancy. Conclusion(s) Participants were aware there is increased cardiovascular risk after HDP, although less aware of risks after gestational hypertension and some specific risks including diabetes. Findings will inform the development of targeted education.

Retrieval of Bard Simon Nitinol inferior vena cava filters: Approaches, technical successes, complications, and clinical outcomes

2021 ◽  
pp. 026835552092598
Author(s):  
Jacob J Bundy ◽  
Jeffrey Forris Beecham Chick ◽  
Ravi N Srinivasa ◽  
Kyle J Cooper ◽  
Joseph J Gemmete ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Inferior Vena Cava Filters ◽  
Vena Cava Filters ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic ◽  
Vena Cava Thrombosis ◽  
Inferior Vena Cava Thrombosis

Objective The Simon Nitinol filter is a bi-level filtration device designed for permanent implantation that is no longer commercially available, but may result in similar complications to current commercially available long term indwelling temporary or permanent filters. Complications related to indwelling inferior vena cava filters include inferior vena cava thrombosis, inferior vena cava penetration, filter migration, and filter fracture. There is a paucity of reports describing the technical aspects related to retrieval of Simon Nitinol filters. Materials and methods This study consisted of five patients with Simon Nitinol filters and describes the indication for retrieval, the retrieval techniques used to remove the filters, technical success, complications, and clinical course. Results The indications for retrieval included: abdominal pain ( n = 2; 40%), iliocaval thrombosis ( n = 1; 20%), identification of an intracardiac filter fragment ( n = 1; 20%), and recurrent venous thromboembolic events ( n = 1; 20%). Retrieval techniques included: biopsy forceps ( n = 3; 60%), excimer laser extraction sheaths ( n = 3; 60%), hangman modified loop snares ( n = 3; 60%), rigid endobronchial forceps ( n = 2; 40%), and balloon deflection ( n = 2; 40%). All filters were successfully retrieved. One patient developed a post-procedural intramuscular hematoma near the site of right internal jugular sheath placement. Conclusions Simon Nitinol filters may be retrieved safely and effectively using advanced inferior vena cava filter retrieval techniques.

Advanced maternal age and the impact on maternal and offspring cardiovascular health

2019 ◽  
Vol 317 (2) ◽  
pp. H387-H394 ◽  
Author(s):  
Christy-Lynn M. Cooke ◽  
Sandra T. Davidge
Keyword(s):  
Cardiovascular Disease ◽  
Maternal Age ◽  
Cardiovascular Health ◽  
Advanced Maternal Age ◽  
Limited Information ◽  
In Utero Environment ◽  
Increased Risk ◽  
Health And Disease ◽  
The Impact

Delaying pregnancy, which is on the rise, may increase the risk of cardiovascular disease in both women and their children. The physiological mechanisms that lead to these effects are not fully understood but may involve inadequate adaptations of the maternal cardiovascular system to pregnancy. Indeed, there is abundant evidence in the literature that a fetus developing in a suboptimal in utero environment (such as in pregnancies complicated by fetal growth restriction, preterm birth, and/or preeclampsia) is at an increased risk of cardiovascular disease in adulthood, the developmental origins of health and disease theory. Although women of advanced age are at a significantly increased risk of pregnancy complications, there is limited information as to whether advanced maternal age constitutes an added stressor on the prenatal environment of the fetus, and whether or not this is secondary to impaired cardiovascular function during pregnancy. This review summarizes the current literature available on the impact of advanced maternal age on cardiovascular adaptations to pregnancy and the role of maternal age on long-term health risks for both the mother and offspring.

Livestock grazing management and biodiversity conservation in Australian temperate grassy landscapes

2004 ◽  
Vol 55 (3) ◽  
pp. 279 ◽  
Author(s):  
J. Dorrough ◽  
A. Yen ◽  
V. Turner ◽  
S. G. Clark ◽  
J. Crosthwaite ◽  
...  
Keyword(s):  
Biodiversity Conservation ◽  
Environmental Sustainability ◽  
Management Practices ◽  
Current Knowledge ◽  
Management Practice ◽  
Management Strategies ◽  
Livestock Grazing ◽  
Grazing Management ◽  
Grazing Strategies

There is an increasing interest in the development of livestock grazing management strategies that achieve environmental sustainability and maintain or improve the long-term production capacity of commercial grazing systems. In temperate Australia, these strategies are generally focussed on reducing perennial pasture decline, soil loss, acidity, and salinity. An additional challenge facing land managers and researchers is developing grazing strategies that also maintain and enhance local and regional biodiversity. However, few studies have assessed the compatibility of management practices for maintaining long-term productivity and biodiversity conservation. We still have only a very basic understanding of the effects of different grazing strategies and pasture management on biodiversity and this is a major impediment to the development of appropriate and compatible best management practice. We argue that although there is an increasing desire to find management strategies that protect and enhance biodiversity without hindering long-term agricultural production, in many cases this may not be possible. Current knowledge suggests that compatibility is most likely to be achieved using low-input systems in low productivity (fragile) landscapes, whereas in highly productive (robust) landscapes there is less opportunity for integration of productive land-use and biodiversity conservation. There is an urgent need for improved communication and collaboration between agronomic and ecological researchers and research agencies to ensure that future programs consider sustainability in terms of biodiversity as well as pasture and livestock productivity and soil and water health.

scholarly journals World kidney day 2011: protect your kidneys, save your heart

2010 ◽  
Vol 13 (1) ◽  
pp. 1228-1231
Author(s):  
William G Couser ◽  
Miguel C Riella
Keyword(s):  
Cardiovascular Disease ◽  
Kidney Disease ◽  
Cardiovascular Health ◽  
International Federation ◽  
Central Component ◽  
Kidney Dysfunction ◽  
Premature Cardiovascular Disease ◽  
Health Strategy ◽  
Early Detection And Prevention

March 10, 2011 will mark the celebration of the 6th World Kidney Day (WKD), an annual event jointly sponsored by the International Society of Nephrology and the International Federation of Kidney Foundations. Since its inception in 2006, WKD has grown dramatically to become the most widely celebrated event associated with kidney disease in the world and the most successful effort to raise awareness among both the general public and government health officials about the dangers of kidney disease, especially chronic kidney disease (CKD). In 2011, WKD will call attention to the large, and often unappreciated, role played by kidney dysfunction in increasing premature cardiovascular disease, the most common cause of morbidity and mortality worldwide (1). Can a focus on early detection and prevention of kidney disease really improve long term cardiovascular health? In this editorial, we hope to convey the message that increased attention to the kidneys can indeed improve long-term health outcomes by reducing both kidney and cardiovascular disease and should therefore be a central component of any global health strategy intended to reduce the enormous and growing burden of chronic NCDs.

scholarly journals Simultaneous arterial and venous thromboembolic events associated with COVID-19. A case report

2021 ◽  
Vol 17 (2) ◽  
Author(s):  
Ashley Reed ◽  
Caroline Howard ◽  
Mohamed Barakat ◽  
Ali Navi
Keyword(s):  
Case Report ◽  
Patent Foramen Ovale ◽  
Holistic Approach ◽  
Foramen Ovale ◽  
Artery Thrombosis ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic ◽  
The Individual ◽  
Support Decision Making

Infections with COVID-19 can induce thrombophilia and increase the risk of thrombotic events. We describe a case of a 64- years-old male who presents with intermediate-risk pulmonary embolism and brachial artery thrombosis secondary to an undiagnosed patent foramen ovale and COVID-19 infection. The patient was successfully treated with thrombolysis and heparin infusions and was discharged home with long-term anticoagulation. Managing patients with multiple pathologies occurring concurrently requires effective inter-speciality working in order to take a holistic approach to managing the patient opposed to managing the conditions in isolation. This case report highlights how clinical guidelines can support decision making of the individual pathologies but working as a team will enable the best care.

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