During pregnancy, there are several coordinated and dynamic maternal adaptations that take place to meet the demands of the growing and developing fetus. This includes significant physiological, endocrine, and metabolic adaptations that produce a diabetogenic state of progressive insulin resistance.^1,2 It is thought that these metabolic adaptations occur so that nutrients, such as glucose, are conserved and directed toward the fetus to sustain its constant nutritional and oxygen requirements. Pregnancy is also associated with significant physiological remodeling of the cardiovascular system, which includes increases in ventricular wall mass, ventricular hypertrophy, myocardial contractility, and cardiac compliance.^1,2 These cardiac adaptations combined with an increase in heart rate and cardiac output further ensure the optimization of nutrient and oxygen delivery to the growing fetus. Although the maternal cardiovascular and metabolic adaptations that allow for optimal nutrient delivery to the fetus during pregnancy are well understood, one particular area where knowledge is lacking in pregnancy relates to maternal cardiac energy metabolism profiles. Because pregnancy results in an increased maternal cardiac hypertrophy, and both physiological and pathophysiological cardiac hypertrophy are associated with several alterations in myocardial energy metabolism,^3,4 it is likely that pregnancy-associated cardiac hypertrophy is also accompanied by altered myocardial metabolism. In support of this, in this issue of Circulation Research, Liu et al⁵ provide evidence that the cardiac hypertrophy associated with late pregnancy is associated with reductions in myocardial glucose oxidation rates and increases in fatty acid oxidation rates (Figure).

Article, see p 1370

Cardiac energy metabolism during pregnancy. The study by Liu et al demonstrates that pregnancy-induced cardiac hypertrophy is associated with alterations in myocardial energy metabolism mimicking that observed in the heart during obesity and diabetes mellitus with an increase in fatty acid oxidation rates and a decrease in …

在怀孕期间，会进行多种协调和动态的母体适应，以满足不断增长和发展中的胎儿的需求。这包括显着的生理，内分泌和代谢适应，这些适应产生了进行性胰岛素抵抗的糖尿病形成状态。^1，2可以认为，这些代谢适应发生使营养物质，如葡萄糖，是保守的并且朝向胎儿涉及维持其恒定的营养和氧气的需要量。怀孕还与心血管系统的重大生理重塑有关，其中包括心室壁质量的增加，心室肥大，心肌收缩力和心脏顺应性。^1，2这些心脏适应性与心率和心输出量的增加相结合，进一步确保了向成长中的胎儿的营养和氧气输送的优化。尽管对孕期心血管和代谢的适应性进行了充分的了解，可以在妊娠期间最佳地向胎儿输送营养，但是孕期缺乏知识的一个特定领域与孕产妇心脏能量代谢状况有关。因为在增加的母体心脏肥大和生理和病理生理学心脏肥大妊娠结果与在心肌能量代谢若干变更，关联^3，4妊娠相关的心脏肥大也可能伴随着心肌代谢的改变。为此，Liu等[ ^5]在《循环研究》杂志上提供了证据，证明与妊娠晚期有关的心脏肥大与心肌葡萄糖氧化速率的降低和脂肪酸氧化速率的提高有关（图）。

文章，请参阅第1370页

怀孕期间心脏能量代谢。Liu等人的研究表明，妊娠引起的心脏肥大与心肌能量代谢改变有关，该改变与肥胖和糖尿病期间心脏中观察到的改变有关，其中脂肪酸氧化率增加，而……降低。