Many crucial cardiovascular adaptations occur in the body during pregnancy to ensure successful gestation. Maladaptation of the cardiovascular system during pregnancy can lead to complications that promote cardiac dysfunction and may lead to heart failure (HF). About 12% of pregnancy-related deaths in the USA have been attributed to HF and the detrimental effects of cardiovascular complications on the heart can be long-lasting, pre-disposing the mother to HF later in life. Indeed, cardiovascular complications such as gestational diabetes mellitus, preeclampsia, gestational hypertension, and peripartum cardiomyopathy have been shown to induce cardiac metabolic dysfunction, oxidative stress, fibrosis, apoptosis, and diastolic and systolic dysfunction in the hearts of pregnant women, all of which are hallmarks of HF. The exact etiology and cardiac pathophysiology of pregnancy-related complications is not yet fully deciphered. Furthermore, diagnosis of cardiac dysfunction in pregnancy is often made only after clinical symptoms are already present, thus necessitating the need for novel diagnostic and prognostic biomarkers. Mounting data demonstrates an altered expression of maternal circulating miRNAs during pregnancy affected by cardiovascular complications. Throughout the past decade, miRNAs have become of growing interest as modulators and biomarkers of pathophysiology, diagnosis, and prognosis in cardiac dysfunction. While the association between pregnancy-related cardiovascular complications and cardiac dysfunction or HF is becoming increasingly evident, the roles of miRNA-mediated regulation herein remain poorly understood. Therefore, this review will summarize current reports on pregnancy-related cardiovascular complications that may lead to cardiac dysfunction and HF during and after pregnancy in previously healthy women, with a focus on the pathophysiological role of miRNAs.

中文翻译：

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妊娠相关的心脏功能障碍和 microRNA 的调节作用。


怀孕期间体内会发生许多重要的心血管适应，以确保成功妊娠。怀孕期间心血管系统的适应不良可能会导致并发症，从而促进心脏功能障碍，并可能导致心力衰竭（HF）。在美国，大约 12% 的妊娠相关死亡归因于心力衰竭，心血管并发症对心脏的有害影响可能是长期的，使母亲在以后的生活中容易患上心力衰竭。事实上，妊娠糖尿病、先兆子痫、妊娠高血压和围产期心肌病等心血管并发症已被证明可诱发孕妇心脏代谢功能障碍、氧化应激、纤维化、细胞凋亡以及心脏舒张和收缩功能障碍。高频的特征。妊娠相关并发症的确切病因和心脏病理生理学尚未完全阐明。此外，妊娠期心功能不全的诊断通常只有在临床症状已经出现后才能进行，因此需要新的诊断和预后生物标志物。越来越多的数据表明，受心血管并发症影响，妊娠期间母体循环 miRNA 的表达发生了变化。在过去的十年中，miRNA 作为心功能障碍病理生理学、诊断和预后的调节剂和生物标志物越来越受到人们的关注。虽然妊娠相关心血管并发症与心功能不全或心力衰竭之间的关联变得越来越明显，但 miRNA 介导的调节作用仍然知之甚少。 因此，本综述将总结目前关于妊娠相关心血管并发症的报道，这些并发症可能导致先前健康的女性妊娠期间和妊娠后心功能不全和心力衰竭，重点关注 miRNA 的病理生理作用。