Publications by authors named "Nandita S Scott"
Background: Preeclampsia is a hypertensive disorder of pregnancy characterized by systemic endothelial dysfunction. The pathophysiology of preeclampsia remains incompletely understood. This study used human venous endothelial cell (EC) transcriptional profiling to investigate potential novel mechanisms underlying EC dysfunction in preeclampsia.
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- Despite progress in recognizing and diagnosing spontaneous coronary artery dissection (SCAD) in the last decade, there is still limited understanding of its mechanisms, contributing factors, and effective treatments.
- The text highlights research gaps in SCAD and suggests strategies like patient advocacy, independent registries, and specialized centers to improve clinical care and research outcomes.
- Additionally, it presents a patient-centered clinical care and research framework developed by the SCAD Alliance and International SCAD registry as a model to enhance understanding and management of this condition.
Cardiovascular disease remains a major contributor to maternal morbidity and mortality in the United States. Cardio Obstetrics is a nascent field for which most cardiovascular clinicians have not received any formal training. This has resulted in knowledge and care gaps.
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- * A total of 114 HF patients participated in the GDMT clinic, showing a remarkable increase in the use of recommended 4-drug therapy—from 21% to 88%—along with higher medication dosages compared to usual care.
- * Results indicated significant improvements in HF symptoms and heart function metrics, with 94% of patients in the GDMT clinic experiencing symptomatic relief after a median treatment length of about 16 weeks.
Article Synopsis
- Maternal mortality in the U.S. is a significant public health issue, with cardiovascular disease (CVD) being a leading cause of related deaths and health complications.
- Labor and delivery pose heightened risks for pregnant individuals with CVD, yet there is varied approach to management due to a lack of high-quality randomized studies.
- To address this, a panel of experts including cardiologists and obstetricians has come together to create practical guidelines for managing labor and delivery for high-risk patients with CVD, covering aspects like delivery method, timing, and use of medical devices.
Article Synopsis
- Preeclampsia is a pregnancy-related condition characterized by high blood pressure and a disruption in the balance of certain proteins, potentially leading to cardiovascular risks due to microvascular dysfunction.
- Researchers compared cardiac function in women with severe preeclampsia to those with normal pregnancies and nonpostpartum controls using advanced imaging techniques to assess myocardial flow and resistance.
- Results indicated that women who had preeclampsia showed significantly decreased blood flow and increased vascular resistance, highlighting reduced coronary microvascular function soon after delivery, which could have long-term health implications.
Article Synopsis
- Preeclampsia is a pregnancy-related condition characterized by high blood pressure and microvascular dysfunction, potentially increasing cardiovascular risks post-pregnancy.
- A study compared women with severe preeclampsia to those with normal pregnancies and non-postpartum controls using cardiac imaging to assess heart function and blood flow.
- Results showed that women who experienced preeclampsia had significantly reduced heart function and increased vascular resistance, indicating potential long-term cardiovascular issues, warranting further investigation for preventive measures.
Maternal Cardiovascular Health Post-DobbsPregnancy is associated with increasing morbidity and mortality in the United States. In the post-Dobbs era, many pregnant patients at highest risk no longer have access to abortion, which has been a crucial component of standard medical care.
View Article and Find Full Text PDFDue to the potential for severe maternal morbidity and even mortality, pregnancy-associated spontaneous coronary artery dissection (P-SCAD) often presents as a clinical conundrum. While current recommendations encourage coronary interventions when medically indicated even during pregnancy, the hesitation still understandably exists. Meanwhile, given the rarity of the condition, the guidelines for management are still based on expert consensus.
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- Hypertensive disorders of pregnancy (HDPs), such as gestational hypertension and preeclampsia, significantly increase risks of maternal health issues and long-term cardiovascular disease across the globe.
- The study aimed to link specific proteins in the blood to HDPs using genetic data, employing two-sample mendelian randomization for analysis.
- Findings involved a broad dataset, including over 393,000 women for gestational hypertension and nearly 607,000 for preeclampsia, uncovering associations between 90 candidate cardiovascular-related proteins and these hypertensive disorders.
Purpose Of Review: Cardiovascular disease is the leading cause of maternal mortality in the USA. All cardiovascular care providers should have a foundational knowledge on the management of pregnant individuals with heart disease. This focused review touches on several key cardio-obstetric themes.
View Article and Find Full Text PDFCardiac biomarkers are widely used in the nonpregnant population when acute cardiovascular (CV) pathology is suspected; however, the behavior of these biomarkers in the context of pregnancy is less well understood. Pregnant individuals often have symptoms that mimic those of cardiac dysfunction, and complications of pregnancy may include CV disease. This paper will summarize our current knowledge on the use of cardiac biomarkers in pregnancy and provide suggestions on how to use these tools in clinical practice based on the available evidence.
View Article and Find Full Text PDFPulmonary arterial hypertension (PAH) is a vasoconstrictive disease of the distal pulmonary vasculature resulting in adverse right heart remodeling. Pregnancy in PAH patients is associated with high maternal morbidity and mortality as well as neonatal and fetal complications. Pregnancy-associated changes in the cardiovascular, pulmonary, hormonal, and thrombotic systems challenge the complex PAH physiology.
View Article and Find Full Text PDFCardiovascular complications are frequently present in coronavirus-2019 (COVID-19) infection. These include microvascular and macrovascular thrombotic complications such as arterial and venous thromboembolism, myocardial injury or inflammation resulting in infarction, heart failure, and arrhythmias. Data suggest increased risk of adverse outcomes in pregnant compared with nonpregnant women of reproductive age with COVID-19 infection, including need for intensive care unit admission, mechanical ventilation, and extracorporeal membrane oxygenation utilization.
View Article and Find Full Text PDFObjective: Whether biomarkers may enable early identification of women who develop peripartum cardiomyopathy (PPCM) prior to disease onset remains a question of interest.
Study Design: A retrospective nested case-control study was conducted to determine whether first trimester -terminal pro-B type natriuretic peptide (NT-proBNP) or high sensitivity cardiac troponin I (hs-cTnI) differed among women who developed PPCM versus unaffected pregnancies. Cases were matched to unaffected women by age, race, parity, and gestational age of sample (control A) and then further by blood pressure and pregnancy weight gain (control B).
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- Infertility may increase the risk of developing heart failure (HF), particularly heart failure with preserved ejection fraction (HFpEF), in postmenopausal women.
- A study followed 38,528 women, finding that 14% reported infertility, and over 15 years, 2,373 developed HF, with a notable link between infertility and HFpEF.
- The connection remained significant even after accounting for other cardiovascular risk factors, which suggests further research is needed to explore the underlying mechanisms of this association.
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- There are no specific guidelines for evaluating and managing blood lipids in women, despite acknowledging their unique cardiovascular risk factors associated with hormonal changes throughout their life cycle.
- The review emphasizes the importance of understanding personalized cholesterol goals and encourages women to collaborate with healthcare providers for effective cardiovascular disease prevention and management.
- It highlights existing biases in dyslipidemia treatment for women and calls for more research to include women in lipid trials to better identify sex-specific differences in lipid management.