Cardiac dysfunction is associated with altered sarcomere ultrastructure in intrauterine growth restriction

Objective The purpose of this study was to assess whether abnormal cardiac function in human fetuses with intrauterine growth restriction (IUGR) is associated with ultrastructural differences in the cardiomyocyte sarcomere. Study Design Nine severe early-onset IUGR fetuses and 9 normally grown fetus...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2014-06, Vol.210 (6), p.550.e1-550.e7
Main Authors: Iruretagoyena, Jesus Igor, MD, Gonzalez-Tendero, Anna, MSc, Garcia-Canadilla, Patricia, MSc, Amat-Roldan, Ivan, PhD, Torre, Iratxe, PhD, Nadal, Alfons, MD, Crispi, Fatima, MD, Gratacos, Eduard, MD
Format: Article
Language:English
Subjects:
cardiac function
cardiomyocyte
Case-Control Studies
Echocardiography
Female
Fetal Growth Retardation - diagnostic imaging
Fetal Growth Retardation - pathology
Fetal Growth Retardation - physiopathology
Fetus - physiopathology
Gestational Age
Humans
intrauterine growth restriction
Myocytes, Cardiac - ultrastructure
Natriuretic Peptide, Brain - analysis
Obstetrics and Gynecology
Pregnancy
sarcomere
Sarcomeres - ultrastructure
second harmonic generation microscopy
Troponin I - analysis
Ultrasonography, Prenatal
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Summary:Objective The purpose of this study was to assess whether abnormal cardiac function in human fetuses with intrauterine growth restriction (IUGR) is associated with ultrastructural differences in the cardiomyocyte sarcomere. Study Design Nine severe early-onset IUGR fetuses and 9 normally grown fetuses (appropriate growth for gestational age) who died in the perinatal period were included prospectively. Cardiac function was assessed by echocardiography and levels of B-type natriuretic peptide and troponin-I. Heart sections were imaged by second harmonic generation microscopy, which allowed unstained visualization of cardiomyocyte's sarcomere length. Results Echocardiographic and biochemical markers showed signs of severe cardiac dysfunction in IUGR fetuses. Second harmonic generation microscopy demonstrated a significantly shorter sarcomere length in IUGR as compared with appropriate growth for gestational age fetuses. Conclusion IUGR is associated with changes in the cardiomyocyte contractile machinery in the form of shorter sarcomere length, which could help to explain the cardiac dysfunction previously documented in IUGR.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2014.01.023