Cardiac and placental imaging (CARP) in pregnancy to assess aetiology of preeclampsia.
CMRI
CVD
MRI
Placenta
Preeclampsia
Pregnancy
Quantitative MRI
Journal
Placenta
ISSN: 1532-3102
Titre abrégé: Placenta
Pays: Netherlands
ID NLM: 8006349
Informations de publication
Date de publication:
05 2022
05 2022
Historique:
received:
25
05
2021
revised:
12
02
2022
accepted:
01
03
2022
pubmed:
18
4
2022
medline:
25
5
2022
entrez:
17
4
2022
Statut:
ppublish
Résumé
The CARP study aims to investigate placental function, cardiac function and fetal growth comprehensively during pregnancy, a time of maximal cardiac stress, to work towards disentangling the complex cardiac and placental interactions presenting in the aetiology of pre-eclampsia as well as predicting maternal Cardiovascular Disease (CVD) risk in later life. The involvement of the cardiovascular system in pre-eclampsia, one of the most serious complications of pregnancy, is evident. While the manifestations of pre-eclampsia during pregnancy (high blood pressure, multi-organ disease, and placental dysfunction) resolve after delivery, a lifelong elevated CVD risk remains. An assessment including both cardiac and placental Magnetic Resonance Imaging (MRI) optimised for use in pregnancy and bespoke to the expected changes was developed. Simultaneous structural and functional MRI data from the placenta, the heart and the fetus were obtained in a total of 32 pregnant women (gestational ages from 18.1 to 37.5 weeks), including uncomplicated pregnancies and five cases with early onset pre-eclampsia. The achieved comprehensive MR acquisition was able to demonstrate a phenotype associated with pre-eclampsia linking both placental and cardiac factors, reduced mean T2* (p < 0.005), increased heterogeneity (p < 0.005) and a trend towards an increase in cardiac work, larger average mass (109.4 vs 93.65 gr), wall thickness (7.0 vs 6.4 mm), blood pool volume (135.7 vs 127.48 mL) and mass to volume ratio (0.82 vs 0.75). The cardiac output in the controls was, controlling for gestational age, positively correlated with placental volume (p < 0.05). The CARP study constitutes the first joint assessment of functional and structural properties of the cardiac system and the placenta during pregnancy. Early indications of cardiac remodelling in pre-eclampsia were demonstrated paving the way for larger studies.
Sections du résumé
INTRODUCTION
The CARP study aims to investigate placental function, cardiac function and fetal growth comprehensively during pregnancy, a time of maximal cardiac stress, to work towards disentangling the complex cardiac and placental interactions presenting in the aetiology of pre-eclampsia as well as predicting maternal Cardiovascular Disease (CVD) risk in later life.
BACKGROUND
The involvement of the cardiovascular system in pre-eclampsia, one of the most serious complications of pregnancy, is evident. While the manifestations of pre-eclampsia during pregnancy (high blood pressure, multi-organ disease, and placental dysfunction) resolve after delivery, a lifelong elevated CVD risk remains.
METHOD
An assessment including both cardiac and placental Magnetic Resonance Imaging (MRI) optimised for use in pregnancy and bespoke to the expected changes was developed. Simultaneous structural and functional MRI data from the placenta, the heart and the fetus were obtained in a total of 32 pregnant women (gestational ages from 18.1 to 37.5 weeks), including uncomplicated pregnancies and five cases with early onset pre-eclampsia.
RESULTS
The achieved comprehensive MR acquisition was able to demonstrate a phenotype associated with pre-eclampsia linking both placental and cardiac factors, reduced mean T2* (p < 0.005), increased heterogeneity (p < 0.005) and a trend towards an increase in cardiac work, larger average mass (109.4 vs 93.65 gr), wall thickness (7.0 vs 6.4 mm), blood pool volume (135.7 vs 127.48 mL) and mass to volume ratio (0.82 vs 0.75). The cardiac output in the controls was, controlling for gestational age, positively correlated with placental volume (p < 0.05).
DISCUSSION
The CARP study constitutes the first joint assessment of functional and structural properties of the cardiac system and the placenta during pregnancy. Early indications of cardiac remodelling in pre-eclampsia were demonstrated paving the way for larger studies.
Identifiants
pubmed: 35430505
pii: S0143-4004(22)00089-3
doi: 10.1016/j.placenta.2022.03.012
pmc: PMC9810538
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
46-55Subventions
Organisme : Wellcome Trust
ID : WT203148/Z/16/Z
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 201374/Z/16/Z
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 209450/Z/17/Z
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/T018119/1
Pays : United Kingdom
Organisme : Department of Health
ID : RP- 2014-05-019
Pays : United Kingdom
Informations de copyright
Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.
Références
Hypertension. 2008 Nov;52(5):873-80
pubmed: 18824660
J Magn Reson Imaging. 2019 Jan;49(1):291-303
pubmed: 30142239
Am J Obstet Gynecol. 2022 Feb;226(2S):S954-S962
pubmed: 33771361
Circulation. 2019 Sep 24;140(13):1050-1060
pubmed: 31545680
Circulation. 2013 Jan 15;127(2):197-206
pubmed: 23224059
Psychiatry Res. 2010 May 30;182(2):160-4
pubmed: 20409694
Int J Obstet Anesth. 2018 Nov;36:56-65
pubmed: 30143429
Med Image Anal. 2011 Dec;15(6):801-13
pubmed: 21788150
Placenta. 2021 Jan 15;104:138-145
pubmed: 33341490
Lancet. 2010 Aug 21;376(9741):631-44
pubmed: 20598363
Hypertension. 2016 Apr;67(4):754-62
pubmed: 26962206
Magn Reson Med. 2019 Feb;81(2):1191-1204
pubmed: 30242899
J Matern Fetal Neonatal Med. 2019 Dec;32(23):3923-3930
pubmed: 29772936
Ultrasound Obstet Gynecol. 2020 Mar;55(3):293-302
pubmed: 31452271
Placenta. 2017 Jan;49:48-54
pubmed: 28012454
Circ Cardiovasc Imaging. 2016 Sep;9(9):
pubmed: 27609819
Cardiovasc J Afr. 2016 Mar-Apr;27(2):89-94
pubmed: 27213856
Circulation. 2014 Aug 19;130(8):703-14
pubmed: 25135127
Front Physiol. 2017 Feb 14;8:68
pubmed: 28261103
BMJ. 2016 Apr 19;353:i1753
pubmed: 27094586
Ultrasound Obstet Gynecol. 2018 Apr;51(4):519-523
pubmed: 28436119
Hypertension. 2020 Nov;76(5):1506-1513
pubmed: 32829667
Ultrasound Obstet Gynecol. 2016 Jun;47(6):748-54
pubmed: 26041014
Magn Reson Med. 2018 Aug;80(2):756-766
pubmed: 29230859
NMR Biomed. 2021 Apr;34(4):e4475
pubmed: 33480110
Placenta. 2019 Mar;78:18-22
pubmed: 30955706
Am J Obstet Gynecol. 2015 Oct;213(4 Suppl):S115-22
pubmed: 26428489
Ultrasound Obstet Gynecol. 2017 Sep;50(3):295-301
pubmed: 28436167
Hypertension. 2020 Jun;75(6):1523-1531
pubmed: 32336233
Rev Esp Cardiol. 2011 Nov;64(11):1045-50
pubmed: 21962953
Neuroimage. 2018 Jun;173:88-112
pubmed: 29409960
Hypertension. 2018 Jul;72(1):24-43
pubmed: 29899139
J Matern Fetal Neonatal Med. 2019 Jan;32(2):293-300
pubmed: 28974131
Ultrasound Obstet Gynecol. 2019 Jul;54(1):35-50
pubmed: 30737852
Magn Reson Med. 2016 Nov;76(5):1551-1562
pubmed: 26599502
Hypertension. 2020 Jun;75(6):1542-1550
pubmed: 32306767
BMJ. 2007 Nov 10;335(7627):974
pubmed: 17975258