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Cardiac angiogenic imbalance leads to peripartum cardiomyopathy

Open access
Patten, Ian S., Rana, Sarosh, Shahul, Sajid, Rowe, Glenn C., Jang, Cholsoon, Liu, Laura, Hacker, Michele R., Rhee, Julie S., Mitchell, John, Mahmood, Feroze, Hess, Philip, Farrell, Caitlin, Koulisis, Nicole, Khankin, Eliyahu V., Burke, Suzanne D., Tudorache, Igor, Bauersachs, Johann, Monte, Federica del, Hilfiker-Kleiner, Denise, Karumanchi, S. Ananth, Arany, Zoltan·2012·Nature

Abstract

Peripartum cardiomyopathy (PPCM) is an often fatal disease that affects pregnant women who are near delivery, and it occurs more frequently in women with pre-eclampsia and/or multiple gestation. The aetiology of PPCM, and why it is associated with pre-eclampsia, remain unknown. Here we show that PPCM is associated with a systemic angiogenic imbalance, accentuated by pre-eclampsia. Mice that lack cardiac PGC-1α, a powerful regulator of angiogenesis, develop profound PPCM. Importantly, the PPCM is entirely rescued by pro-angiogenic therapies. In humans, the placenta in late gestation secretes VEGF inhibitors like soluble FLT1 (sFLT1), and this is accentuated by multiple gestation and pre-eclampsia. This anti-angiogenic environment is accompanied by subclinical cardiac dysfunction, the extent of which correlates with circulating levels of sFLT1. Exogenous sFLT1 alone caused diastolic dysfunction in wild-type mice, and profound systolic dysfunction in mice lacking cardiac PGC-1α. Finally, plasma samples from women with PPCM contained abnormally high levels of sFLT1. These data indicate that PPCM is mainly a vascular disease, caused by excess anti-angiogenic signalling in the peripartum period. The data also explain how late pregnancy poses a threat to cardiac homeostasis, and why pre-eclampsia and multiple gestation are important risk factors for the development of PPCM.

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Metadata

Authors
Patten, I. S., Rana, S., Shahul, S., Rowe, G. C., Jang, C., Liu, L., Hacker, M. R., Rhee, J. S., Mitchell, J., Mahmood, F., Hess, P., Farrell, C., Koulisis, N., Khankin, E. V., Burke, S. D., Tudorache, I., Bauersachs, J., Monte, F. D., Hilfiker-Kleiner, D., Karumanchi, S. A., & Arany, Z.
Venue
Nature
Published
2012-05
Volume
485
Issue
7398
Pages
333-338
ISSN
  • 0028-0836 (ISSN-L)
  • 1476-4687
OpenAlex
W2100128206
Cited by
572
References
8
FWCI
24.94
Type
journal article
Language
en
Open access
green

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CoChat. (2026). Citation check: Cardiac angiogenic imbalance leads to peripartum cardiomyopathy. https://app.cochat.ai/papers/10.1038/nature11040
The paper
Patten, I. S., Rana, S., Shahul, S., Rowe, G. C., Jang, C., Liu, L., Hacker, M. R., Rhee, J. S., Mitchell, J., Mahmood, F., Hess, P., Farrell, C., Koulisis, N., Khankin, E. V., Burke, S. D., Tudorache, I., Bauersachs, J., Monte, F. D., Hilfiker-Kleiner, D., . . . Arany, Z. (2012). Cardiac angiogenic imbalance leads to peripartum cardiomyopathy. Nature. https://doi.org/10.1038/nature11040

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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