The American journal of the medical sciences
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Review
Pregnancy-induced Cardiovascular Pathologies: Importance of Structural Components and Lipids.
Pregnancy leads to adaptations for maternal and fetal energy needs. The cardiovascular system bears the brunt of the adaptations as the heart and vessels enable nutrient supply to maternal organs facilitated by the placenta to the fetus. The components of the cardiovascular system are critical in the balance between maternal homeostatic and fetus driven homeorhetic regulation. ⋯ Here, the cardiovascular components and functional derangements associated with cardiovascular pathology in pregnancy, vis-à-vis lipid deposition, mobilization and maternal and/or cardiac and fetal energy needs are detailed. Most reports on the components and associated pathology in pregnancy, are on derangements affecting the extracellular matrix and epicardial fat, followed by the endothelium, vascular smooth muscle, pericytes and myocytes. Targeted studies on all cardiovascular components and pathological outcomes in pregnancy will enhance targeted interventions.
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Comparative Study
Lower Post Myocardial Infarction Mortality Among Women Treated at Veterans Affairs Hospitals Compared to Men.
There is conflicting evidence about whether mortality after myocardial infarction is higher among women than among men. This study aimed to compare sex differences in post myocardial infarction mortality in the Veterans Affairs system, a setting where the predominant subjects are men. ⋯ In a health care system where the predominant subjects are men, women had better short- and long-term survival than men after an acute myocardial infarction. Further investigation is warranted to determine the reasons behind the improved outcomes in women post myocardial infarction in the veteran population.
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Physical activity plays an important role in the prevention of cardio-metabolic diseases. The present study evaluated the effect of habitual physical activity on body composition, peak oxygen consumption, cardiac and metabolic function. ⋯ Increased levels of habitual physical activity improve body composition and peak oxygen consumption but appears to have limited effect cardio-metabolic function in middle-aged women.
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Patients with cystic fibrosis (CF) are at risk for CF-related bone disease. Women with CF may use estrogen supplementation for reasons other than skeletal health. It is unknown whether estrogen therapy has a beneficial impact on skeletal health in women with CF. ⋯ Our study demonstrates that few women with CF of reproductive age are prescribed estrogen therapy. Furthermore, estrogen exposure up to age 21 is associated with improved BMD, but estrogen exposure after age 21 does not appear to be associated with improved BMD. Further studies are needed to understand the reasons for the low rates of estrogen use in young women with CF and the optimal timing, dose and formulation of estrogen prescription.