Am J Cardiovasc Dis 2012;2(3):192-207
Review Article
New frontiers in heart hypertrophy during pregnancy
Jingyuan Li, Soban Umar, Marjan Amjedi, Andrea Iorga, Salil Sharma, Rangarajan D Nadadur, Vera Regitz-Zagrosek,
Mansoureh Eghbali
Departments of Anesthesiology and Cardiovascular Research Laboratories, David Geffen School of Medicine at UCLA, Los
Angeles, CA, USA; Institute of Gender in Medicine and Center for Cardiovascular Research, Charite University Hospital,
Berlin, Germany
Received June 6, 2012; accepted July 12, 2012; Epub July 25, 2012; Published August 15, 2012
Abstract: During Pregnancy, heart develops physiological left ventricular hypertrophy as a result of the natural volume
overload. Previously we have characterized the molecular and functional signature of heart hypertrophy during pregnancy.
Cardiac hypertrophy during pregnancy is a complex process that involves many changes including in the signalling
pathways, composition of extracellular matrix as well as the levels of sex hormones. This review summarises the recent
advances and the new frontiers in the context of heart hypertrophy during pregnancy. In particular we focus on structural
and extracellular matrix remodelling as well as signalling pathways in pregnancy-induced physiological heart hypertrophy.
Emerging evidence shows that various microRNAs modulate key components of hypertrophy, therefore the role of
microRNAs in the regulation of gene expression in pregnancy induced hypertrophy is also discussed. We also review the
role of ubiquitin proteasome system, the major machinery for the degradation of damaged and misfolded proteins, in heart
hypertrophy. The role of sex hormones in particular estrogen in cardiac remodeling during pregnancy is also discussed.
We also review pregnancy-induced cardiovascular complications such as peripartum cardiomyopathy and pre-eclampsia
and how the knowledge from the animal studies may help us to develop new therapeutic strategies for better treatment of
cardiovascular diseases during pregnancy. Special emphasis has to be given to the guidelines on disease management
in pregnancy. (AJCD1206001).
Keywords: Pregnancy, physiological heart hypertrophy, signalling pathway, peripartum cardiomyopathy, preeclampsia
Address all correspondence to:
Dr. Mansoureh Eghbali
UCLA School of Medicine
Department of Anesthesiology
BH-160CHS, Los Angeles, CA, USA.
Tel: (310) 206-0345; Fax: (310) 825-6649
E-mail: meghbali@ucla.edu
Review Article
New frontiers in heart hypertrophy during pregnancy
Jingyuan Li, Soban Umar, Marjan Amjedi, Andrea Iorga, Salil Sharma, Rangarajan D Nadadur, Vera Regitz-Zagrosek,
Mansoureh Eghbali
Departments of Anesthesiology and Cardiovascular Research Laboratories, David Geffen School of Medicine at UCLA, Los
Angeles, CA, USA; Institute of Gender in Medicine and Center for Cardiovascular Research, Charite University Hospital,
Berlin, Germany
Received June 6, 2012; accepted July 12, 2012; Epub July 25, 2012; Published August 15, 2012
Abstract: During Pregnancy, heart develops physiological left ventricular hypertrophy as a result of the natural volume
overload. Previously we have characterized the molecular and functional signature of heart hypertrophy during pregnancy.
Cardiac hypertrophy during pregnancy is a complex process that involves many changes including in the signalling
pathways, composition of extracellular matrix as well as the levels of sex hormones. This review summarises the recent
advances and the new frontiers in the context of heart hypertrophy during pregnancy. In particular we focus on structural
and extracellular matrix remodelling as well as signalling pathways in pregnancy-induced physiological heart hypertrophy.
Emerging evidence shows that various microRNAs modulate key components of hypertrophy, therefore the role of
microRNAs in the regulation of gene expression in pregnancy induced hypertrophy is also discussed. We also review the
role of ubiquitin proteasome system, the major machinery for the degradation of damaged and misfolded proteins, in heart
hypertrophy. The role of sex hormones in particular estrogen in cardiac remodeling during pregnancy is also discussed.
We also review pregnancy-induced cardiovascular complications such as peripartum cardiomyopathy and pre-eclampsia
and how the knowledge from the animal studies may help us to develop new therapeutic strategies for better treatment of
cardiovascular diseases during pregnancy. Special emphasis has to be given to the guidelines on disease management
in pregnancy. (AJCD1206001).
Keywords: Pregnancy, physiological heart hypertrophy, signalling pathway, peripartum cardiomyopathy, preeclampsia
Address all correspondence to:
Dr. Mansoureh Eghbali
UCLA School of Medicine
Department of Anesthesiology
BH-160CHS, Los Angeles, CA, USA.
Tel: (310) 206-0345; Fax: (310) 825-6649
E-mail: meghbali@ucla.edu
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