Association of activin A and postpartum blood pressure in peripartum cardiomyopathy.


Journal

Pregnancy hypertension
ISSN: 2210-7797
Titre abrégé: Pregnancy Hypertens
Pays: Netherlands
ID NLM: 101552483

Informations de publication

Date de publication:
Dec 2023
Historique:
received: 20 01 2023
revised: 27 08 2023
accepted: 06 10 2023
medline: 5 12 2023
pubmed: 19 10 2023
entrez: 18 10 2023
Statut: ppublish

Résumé

Activin A has been implicated in the pathogenesis of patients with chronic hypertension and heart failure as well as patients with hypertensive disorders of pregnancy (HDP). Whether activin A correlates with blood pressure in patients with peripartum cardiomyopathy (PPCM) and HDP history has not previously been explored. 82 women with PPCM w/ and w/out HDP or hypertension history were selected for analysis from the Investigations in Pregnancy Associated Cardiomyopathy (IPAC) study. Serum biomarkers and blood pressure were assessed at the time of enrollment (median postpartum day 24). Levels of both sFlt-1 (SBP: r 0.47, p = 0.008; DBP: r 0.57, p < 0.001) and activin A (SBP: r 0.59, p < 0.001;DBP: r 0.68, p < 0.001) were noted to significantly correlate with blood pressure in patients with a history of HDP who went on to develop PPCM, but not in patients with chronic hypertension or no hypertensive history. The strongest correlation was between activin A levels and postpartum diastolic blood pressure for the subset with preeclampsia (DBP: r0.82, p < 0.001). This remained significant in multivariable linear regression analysis (DBP: β = 0.011, p = 0.015). In patients with PPCM, activin A and sFlt-1 levels had direct correlations with both systolic (SBP) and diastolic blood pressures (DBP), but only in participants with history of HDP. This correlation was more evident for activin A and strongest with a history of preeclampsia. Our findings suggest that activin A may play an important role in blood pressure modulation in women with HDP who subsequently develop PPCM.

Sections du résumé

BACKGROUND BACKGROUND
Activin A has been implicated in the pathogenesis of patients with chronic hypertension and heart failure as well as patients with hypertensive disorders of pregnancy (HDP). Whether activin A correlates with blood pressure in patients with peripartum cardiomyopathy (PPCM) and HDP history has not previously been explored.
METHODS AND RESULTS RESULTS
82 women with PPCM w/ and w/out HDP or hypertension history were selected for analysis from the Investigations in Pregnancy Associated Cardiomyopathy (IPAC) study. Serum biomarkers and blood pressure were assessed at the time of enrollment (median postpartum day 24). Levels of both sFlt-1 (SBP: r 0.47, p = 0.008; DBP: r 0.57, p < 0.001) and activin A (SBP: r 0.59, p < 0.001;DBP: r 0.68, p < 0.001) were noted to significantly correlate with blood pressure in patients with a history of HDP who went on to develop PPCM, but not in patients with chronic hypertension or no hypertensive history. The strongest correlation was between activin A levels and postpartum diastolic blood pressure for the subset with preeclampsia (DBP: r0.82, p < 0.001). This remained significant in multivariable linear regression analysis (DBP: β = 0.011, p = 0.015).
CONCLUSION CONCLUSIONS
In patients with PPCM, activin A and sFlt-1 levels had direct correlations with both systolic (SBP) and diastolic blood pressures (DBP), but only in participants with history of HDP. This correlation was more evident for activin A and strongest with a history of preeclampsia. Our findings suggest that activin A may play an important role in blood pressure modulation in women with HDP who subsequently develop PPCM.

Identifiants

pubmed: 37852074
pii: S2210-7789(23)00227-1
doi: 10.1016/j.preghy.2023.10.002
pii:
doi:

Substances chimiques

activin A 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

60-66

Informations de copyright

Copyright © 2023 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: SR reports serving as a consultant for Roche Diagnostics, Thermo Fisher, Beckman Coulter, Siemens, and has received research funding from Roche Diagnostics and Siemens for work related to angiogenic biomarkers that are unrelated to the submitted work.

Auteurs

Agnes Koczo (A)

University of Pittsburgh Medical Center, Pittsburgh, PA, United States. Electronic address: koczoa@upmc.edu.

Amy Marino (A)

University of Pittsburgh Medical Center, Pittsburgh, PA, United States.

Vincenzo B Polsinelli (VB)

University of Colorado, Aurora, CO, United States.

Rami Alharethi (R)

Intermountain Medical Center, UT, United States.

Julie Damp (J)

Vanderbilt University, Nashville, TN, United States.

Gregory Ewald (G)

Washington University in St Louis, St Louis, MO, United States.

Michael M Givertz (MM)

Brigham and Women's Hospital, Boston, MA, United States.

John Boehmer (J)

Penn State Hershey Medical Center, Hershey, PA, United States.

Karen Hanley-Yanez (K)

University of Pittsburgh Medical Center, Pittsburgh, PA, United States.

Sarosh Rana (S)

University of Chicago, Chicago, IL, United States.

Jason Roh (J)

Massachusetts General Hospital, Boston, MA, United States.

Dennis M McNamara (DM)

University of Pittsburgh Medical Center, Pittsburgh, PA, United States.

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Classifications MeSH