1. Physiology of the fetal and transitional circulation.
1. 胎儿和过渡循环的生理学。
作者:Finnemore Anna , Groves Alan
期刊:Seminars in fetal & neonatal medicine
日期:2015-04-25
DOI :10.1016/j.siny.2015.04.003
The fetal circulation is an entirely transient event, not replicated at any point in later life, and functionally distinct from the pediatric and adult circulations. Understanding of the physiology of the fetal circulation is vital for accurate interpretation of hemodynamic assessments in utero, but also for management of circulatory compromise in premature infants, who begin extrauterine life before the fetal circulation has finished its maturation. This review summarizes the key classical components of circulatory physiology, as well as some of the newer concepts of physiology that have been appreciated in recent years. The immature circulation has significantly altered function in all aspects of circulatory physiology. The mechanisms and significance of these differences are also discussed, as is the impact of these alterations on the circulatory transition of infants born prematurely.
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1区Q1影响因子: 8.4
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2. Pathophysiology of placental-derived fetal growth restriction.
2. 胎盘衍生的胎儿生长受限的病理生理学。
作者:Burton Graham J , Jauniaux Eric
期刊:American journal of obstetrics and gynecology
日期:2018-02-01
DOI :10.1016/j.ajog.2017.11.577
Placental-related fetal growth restriction arises primarily due to deficient remodeling of the uterine spiral arteries supplying the placenta during early pregnancy. The resultant malperfusion induces cell stress within the placental tissues, leading to selective suppression of protein synthesis and reduced cell proliferation. These effects are compounded in more severe cases by increased infarction and fibrin deposition. Consequently, there is a reduction in villous volume and surface area for maternal-fetal exchange. Extensive dysregulation of imprinted and nonimprinted gene expression occurs, affecting placental transport, endocrine, metabolic, and immune functions. Secondary changes involving dedifferentiation of smooth muscle cells surrounding the fetal arteries within placental stem villi correlate with absent or reversed end-diastolic umbilical artery blood flow, and with a reduction in birthweight. Many of the morphological changes, principally the intraplacental vascular lesions, can be imaged using ultrasound or magnetic resonance imaging scanning, enabling their development and progression to be followed in vivo. The changes are more severe in cases of growth restriction associated with preeclampsia compared to those with growth restriction alone, consistent with the greater degree of maternal vasculopathy reported in the former and more extensive macroscopic placental damage including infarcts, extensive fibrin deposition and microscopic villous developmental defects, atherosis of the spiral arteries, and noninfectious villitis. The higher level of stress may activate proinflammatory and apoptotic pathways within the syncytiotrophoblast, releasing factors that cause the maternal endothelial cell activation that distinguishes between the 2 conditions. Congenital anomalies of the umbilical cord and placental shape are the only placental-related conditions that are not associated with maldevelopment of the uteroplacental circulation, and their impact on fetal growth is limited.
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3区Q1影响因子: 3.4
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3. Development of the Human Placenta and Fetal Heart: Synergic or Independent?
3. 人类胎盘和胎儿心脏的发育:协同还是独立?
作者:Burton Graham J , Jauniaux Eric
期刊:Frontiers in physiology
日期:2018-04-12
DOI :10.3389/fphys.2018.00373
The placenta is the largest fetal organ, and toward the end of pregnancy the umbilical circulation receives at least 40% of the biventricular cardiac output. It is not surprising, therefore, that there are likely to be close haemodynamic links between the development of the placenta and the fetal heart. Development of the placenta is precocious, and in advance of that of the fetus. The placenta undergoes considerable remodeling at the end of the first trimester of pregnancy, and its vasculature is capable of adapting to environmental conditions and to variations in the blood supply received from the mother. There are two components to the placental membranes to consider, the secondary yolk sac and the chorioallantoic placenta. The yolk sac is the first of the extraembryonic membranes to be vascularized, and condensations in the mesenchyme at ~17 days post-conception (p.c.) give rise to endothelial and erythroid precursors. A network of blood vessels is established ~24 days p.c., with the vitelline vein draining through the region of the developing liver into the sinus venosus. Gestational sacs of early pregnancy failures often display aberrant development of the yolk sac, which is likely to be secondary to abnormal fetal development. Vasculogenesis occurs in the villous mesenchyme of the chorioallantoic placenta at a similarly early stage. Nucleated erythrocytes occupy the lumens of the placental capillaries and end-diastolic flow is absent in the umbilical arterial circulation throughout most of the first trimester, indicating a high resistance to blood flow. Resistance begins to fall in the umbilico-placental circulation around 12-14 weeks. During normal early pregnancy the placental capillary network is plastic, and considerable remodeling occurs in response to the local oxygen concentration, and in particular to oxidative stress. In pregnancies complicated by preeclampsia and/or fetal growth restriction, utero-placental malperfusion induces smooth muscle cells surrounding the placental arteries to dedifferentiate and adopt a proliferative phenotype. This change is associated with increased umbilical resistance measured by Doppler ultrasound, and is likely to exert a major effect on the developing heart through the afterload. Thus, both the umbilical and maternal placental circulations may impact on development of the heart.
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4区Q3影响因子: 2.5
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4. Hypoxia and fetal heart development.
4. 缺氧和胎儿心脏发育。
作者:Patterson A J , Zhang L
期刊:Current molecular medicine
日期:2010-10-01
DOI :10.2174/156652410792630643
Fetal hearts show a remarkable ability to develop under hypoxic conditions. The metabolic flexibility of fetal hearts allows sustained development under low oxygen conditions. In fact, hypoxia is critical for proper myocardial formation. Particularly, hypoxia inducible factor 1 (HIF-1) and vascular endothelial growth factor play central roles in hypoxia-dependent signaling in fetal heart formation, impacting embryonic outflow track remodeling and coronary vessel growth. Although HIF is not the only gene involved in adaptation to hypoxia, its role places it as a central figure in orchestrating events needed for adaptation to hypoxic stress. Although "normal" hypoxia (lower oxygen tension in the fetus as compared with the adult) is essential in heart formation, further abnormal hypoxia in utero adversely affects cardiogenesis. Prenatal hypoxia alters myocardial structure and causes a decline in cardiac performance. Not only are the effects of hypoxia apparent during the perinatal period, but prolonged hypoxia in utero also causes fetal programming of abnormality in the heart's development. The altered expression pattern of cardioprotective genes such as protein kinase c epsilon, heat shock protein 70, and endothelial nitric oxide synthase, likely predispose the developing heart to increased vulnerability to ischemia and reperfusion injury later in life. The events underlying the long-term changes in gene expression are not clear, but likely involve variation in epigenetic regulation.
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2区Q1影响因子: 3.6
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5. The heart of the neural crest: cardiac neural crest cells in development and regeneration.
5. 神经嵴的核心:心脏神经嵴细胞的发展和再生。
作者:George Rajani M , Maldonado-Velez Gabriel , Firulli Anthony B
期刊:Development (Cambridge, England)
日期:2020-10-15
DOI :10.1242/dev.188706
Cardiac neural crest cells (cNCCs) are a migratory cell population that stem from the cranial portion of the neural tube. They undergo epithelial-to-mesenchymal transition and migrate through the developing embryo to give rise to portions of the outflow tract, the valves and the arteries of the heart. Recent lineage-tracing experiments in chick and zebrafish embryos have shown that cNCCs can also give rise to mature cardiomyocytes. These cNCC-derived cardiomyocytes appear to be required for the successful repair and regeneration of injured zebrafish hearts. In addition, recent work examining the response to cardiac injury in the mammalian heart has suggested that cNCC-derived cardiomyocytes are involved in the repair/regeneration mechanism. However, the molecular signature of the adult cardiomyocytes involved in this repair is unclear. In this Review, we examine the origin, migration and fates of cNCCs. We also review the contribution of cNCCs to mature cardiomyocytes in fish, chick and mice, as well as their role in the regeneration of the adult heart.
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4区Q4影响因子: 1.2
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6. Changing prevalence of severe congenital heart disease: Results from the National Register for Congenital Heart Defects in Germany.
6. 更改严重的先天性心脏疾病患病率:从人口登记结果在德国的先天性心脏病。
作者:Pfitzer Constanze , Helm Paul C , Ferentzi Hannah , Rosenthal Lisa-Maria , Bauer Ulrike M M , Berger Felix , Schmitt Katharina R L
期刊:Congenital heart disease
日期:2017-07-18
DOI :10.1111/chd.12515
OBJECTIVE:To assess the prevalence of congenital heart disease (CHD) in Germany in relation to phenotypes, severity and gender. DESIGN:Cross-sectional registry study. SETTING:We analyzed data from patients with CHD born between 1996 and 2015. PATIENTS:A total of 26 630 patients, registered with the NRCHD, were born between 1996 and 2015. 10 927 patients were excluded from the current analysis due to prior registration with the NRCHD under the German PAN Prevalence Study, which showed a potential bias in the inclusion of this patient population (proportion of mild cardiac lesions was comparatively high due to improved diagnostic capability for earlier identifying minor lesions). At least 15 703 patients with demographic data and detailed medical information were included in the current study. INTERVENTIONS:None. OUTCOME MEASURES:Prevalence of CHD in Germany differentiated into gender, severity, and phenotype. RESULTS:In total, 15 703 patients with CHD (47.1% female) were included in this study. The five most common phenotypes were found to be ventricular septal defect (19.2%), atrial septal defect (13.0%), Tetralogy of Fallot (9.3%), univentricular heart (9.4%), and coractation of the aortae (7.0%). The prevalence of CHD in regard to severity changed over the duration of the observation period. From 1996 to 2007, the number of simple CHD rose steadily (P < .001), whereas the number of severe CHD has grown significantly since 2008/2009 (P < .001). In regard to gender, the prevalence of simple CHD was higher in females, whereas complex lesions were more common in males (P < .001). CONCLUSIONS:Our study shows a growing number of registered severe CHD in the recent decade in Germany. This development is noteworthy as it implicates a growing demand for first intensive hospital care, expert pediatric cardiologic aftercare, and consequently higher economic impact for this patient population.
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1区Q1影响因子: 38.6
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7. Diagnosis and Management of Noncardiac Complications in Adults With Congenital Heart Disease: A Scientific Statement From the American Heart Association.
7. 诊断和成人先天性心脏病非心脏并发症的管理:科学的表述从美国心脏协会。
作者:Lui George K , Saidi Arwa , Bhatt Ami B , Burchill Luke J , Deen Jason F , Earing Michael G , Gewitz Michael , Ginns Jonathan , Kay Joseph D , Kim Yuli Y , Kovacs Adrienne H , Krieger Eric V , Wu Fred M , Yoo Shi-Joon ,
期刊:Circulation
日期:2017-10-09
DOI :10.1161/CIR.0000000000000535
Life expectancy and quality of life for those born with congenital heart disease (CHD) have greatly improved over the past 3 decades. While representing a great advance for these patients, who have been able to move from childhood to successful adult lives in increasing numbers, this development has resulted in an epidemiological shift and a generation of patients who are at risk of developing chronic multisystem disease in adulthood. Noncardiac complications significantly contribute to the morbidity and mortality of adults with CHD. Reduced survival has been documented in patients with CHD with renal dysfunction, restrictive lung disease, anemia, and cirrhosis. Furthermore, as this population ages, atherosclerotic cardiovascular disease and its risk factors are becoming increasingly prevalent. Disorders of psychosocial and cognitive development are key factors affecting the quality of life of these individuals. It is incumbent on physicians who care for patients with CHD to be mindful of the effects that disease of organs other than the heart may have on the well-being of adults with CHD. Further research is needed to understand how these noncardiac complications may affect the long-term outcome in these patients and what modifiable factors can be targeted for preventive intervention.
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2区Q1影响因子: 5.3
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8. Physical Functioning, Mental Health, and Quality of Life in Different Congenital Heart Defects: Comparative Analysis in 3538 Patients From 15 Countries.
8. 不同先天性心脏缺损的身体作用,心理健康和生活质量:3538名来自15个国家的患者比较分析。
作者:Moons Philip , Luyckx Koen , Thomet Corina , Budts Werner , Enomoto Junko , Sluman Maayke A , Lu Chun-Wei , Jackson Jamie L , Khairy Paul , Cook Stephen C , Chidambarathanu Shanthi , Alday Luis , Eriksen Katrine , Dellborg Mikael , Berghammer Malin , Johansson Bengt , Mackie Andrew S , Menahem Samuel , Caruana Maryanne , Veldtman Gruschen , Soufi Alexandra , Fernandes Susan M , White Kamila , Callus Edward , Kutty Shelby , Ombelet Fouke , Apers Silke , Kovacs Adrienne H ,
期刊:The Canadian journal of cardiology
日期:2020-04-06
DOI :10.1016/j.cjca.2020.03.044
BACKGROUND:We compared physical functioning, mental health, and quality of life (QoL) of patients with different subtypes of congenital heart disease (CHD) in a large international sample and investigated the role of functional class in explaining the variance in outcomes across heart defects. METHODS:In the cross-sectional Assessment of Patterns of Patient-Reported Outcome in Adults with Congenital Heart Disease-International Study (APPROACH-IS), we enrolled 4028 adult patients with CHD from 15 countries. Diagnostic groups with at least 50 patients were included in these analyses, yielding a sample of 3538 patients (median age: 32 years; 52% women). Physical functioning, mental health, and QoL were measured with the SF-12 health status survey, Hospital Anxiety and Depression Scale (HADS), linear analog scale (LAS) and Satisfaction with Life Scale, respectively. Functional class was assessed using the patient-reported New York Heart Association (NYHA) class. Multivariable general linear mixed models were applied to assess the relationship between the type of CHD and patient-reported outcomes, adjusted for patient characteristics, and with country as random effect. RESULTS:Patients with coarctation of the aorta and those with isolated aortic valve disease reported the best physical functioning, mental health, and QoL. Patients with cyanotic heart disease or Eisenmenger syndrome had worst outcomes. The differences were statistically significant, above and beyond other patient characteristics. However, the explained variances were small (0.6% to 4.1%) and decreased further when functional status was added to the models (0.4% to 0.9%). CONCLUSIONS:Some types of CHD predict worse patient-reported outcomes. However, it appears that it is the functional status associated with the heart defect rather than the heart defect itself that shapes the outcomes.
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2区Q1影响因子: 8
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9. Early-life exposure to widespread environmental toxicants and maternal-fetal health risk: A focus on metabolomic biomarkers.
9. 生命早期接触到广泛的环境毒物及母婴健康风险:注重代谢的生物标志物。
作者:Dai Yifeng , Huo Xia , Cheng Zhiheng , Faas Marijke M , Xu Xijin
期刊:The Science of the total environment
日期:2020-06-03
DOI :10.1016/j.scitotenv.2020.139626
Prenatal exposure to widespread environmental toxicants is detrimental to maternal health and fetal development. The effects of environmental toxicants on maternal and fetal metabolic profile changes have not yet been summarized. This systematic review aims to summarize the current studies exploring the association between prenatal exposure to environmental toxicants and metabolic profile alterations in mother and fetus. We searched the MEDLINE (PubMed) electronic database for relevant literature conducted up to September 18, 2019 with some key terms. From the initial 155 articles, 15 articles met the inclusion and exclusion criteria, and consist of highly heterogeneous research methods. Seven studies assessed the effects of multiple environmental pollutants (metals, organic pollutants, nicotine, air pollutants) on the maternal urine and blood metabolomic profile; five studies evaluated the effects of arsenic, polychlorinated biphenyls (PCBs), nicotine, and ambient fine particulate matter (PM) on the cord blood metabolomic profile; and one study assessed the effects of smoking exposure on the amniotic fluid metabolomic profile. The alteration of metabolic pathways in these studies mainly involve energy metabolism, hormone metabolism, oxidative stress and inflammation. No population study investigated the association between environmental toxicants and placental metabolomics. This systematic review provides evidence that prenatal exposure to a variety of environmental pollutants can affect maternal and fetal metabolomic characteristics. Integration of environmental toxicant exposure and metabolomics data in maternal-fetal samples is helpful to understand the interaction between toxicants and metabolites, so as to reveal the pathogenesis of fetal disease or diseases of fetal origin.
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3区Q2影响因子: 5.8
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10. Association between particulate matter air pollution and cardiovascular disease mortality in Lanzhou, China.
10. 在兰州,中国颗粒物空气污染与心血管疾病死亡率之间的关联。
作者:Wu Tingting , Ma Yuan , Wu Xuan , Bai Ming , Peng Yu , Cai Weiting , Wang Yongxiang , Zhao Jing , Zhang Zheng
期刊:Environmental science and pollution research international
日期:2019-03-30
DOI :10.1007/s11356-019-04742-w
Ambient particulate matter (PM) pollution has been linked to elevated mortality, especially from cardiovascular diseases. However, evidence on the effects of particulate matter pollution on cardiovascular mortality is still limited in Lanzhou, China. This research aimed to examine the associations of daily mean concentrations of ambient air pollutants (PM, PM, and PM) and cardiovascular mortality due to overall and cause-specific diseases in Lanzhou. Data representing daily cardiovascular mortality rates, meteorological factors (daily average temperature, daily average humidity, and atmospheric pressure), and air pollutants (PM, PM, SO, NO) were collected from January 1, 2014, to December 31, 2017, in Lanzhou. A quasi-Poisson regression model combined with a distributed lag non-linear model (DLNM) was used to estimate the associations. Stratified analyses were also performed by different cause-specific diseases, including cerebrovascular disease (CD), ischemic heart disease (IHD), heart rhythm disturbances (HRD), and heart failure (HF). The results showed that elevated concentration of PM, PM, and PM had different effects on mortality of different cardiovascular diseases. Only cerebrovascular disease showed a significant positive association with elevated PM. Positive associations were identified between PM and daily mortality rates from total cardiovascular diseases, cerebrovascular diseases, and ischemic heart diseases. Besides, increased concentration of PM was correlated with increased death of cerebrovascular diseases and ischemic heart diseases. For cerebrovascular disease, each 10 μg/m increase in PM at lag4 was associated with increments of 1.22% (95% CI 0.11-2.35%). The largest significant effects for PM on cardiovascular diseases and ischemic heart diseases were both observed at lag0, and a 10 μg/m increment in concentration of PM was associated with 0.47% (95% CI 0.06-0.88%) and 0.85% (95% CI 0.18-1.52%) increases in cardiovascular mortality and ischemic heart diseases. In addition, it exhibited a lag effect on cerebrovascular mortality as well, which was most significant at lag6d, and an increase of 10 μg/m in PM was associated with a 0.76% (95% CI 0.16-1.37%) increase in cerebrovascular mortality. The estimates of percentage change in daily mortality rates per 10 μg/m increase in PM were 0.52% (95% CI 0.05-1.02%) for cerebrovascular disease at lag6 and 0.53% (95% CI 0.01-1.05%) for ischemic heart disease at lag0, respectively. Our study suggests that elevated concentration of atmospheric PM (PM, PM, and PM) in Lanzhou is associated with increased mortality of cardiovascular diseases and that the health effect of elevated concentration of PM is more significant than that of PM and PM.
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1区Q1影响因子: 8.6
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11. Air Pollution and Noncommunicable Diseases: A Review by the Forum of International Respiratory Societies' Environmental Committee, Part 2: Air Pollution and Organ Systems.
11. 空气污染和非传染性疾病:由国际呼吸社环境委员会论坛进行审查,第2部分:空气污染和器官系统。
期刊:Chest
日期:2018-11-09
DOI :10.1016/j.chest.2018.10.041
Although air pollution is well known to be harmful to the lung and airways, it can also damage most other organ systems of the body. It is estimated that about 500,000 lung cancer deaths and 1.6 million COPD deaths can be attributed to air pollution, but air pollution may also account for 19% of all cardiovascular deaths and 21% of all stroke deaths. Air pollution has been linked to other malignancies, such as bladder cancer and childhood leukemia. Lung development in childhood is stymied with exposure to air pollutants, and poor lung development in children predicts lung impairment in adults. Air pollution is associated with reduced cognitive function and increased risk of dementia. Particulate matter in the air (particulate matter with an aerodynamic diameter < 2.5 μm) is associated with delayed psychomotor development and lower child intelligence. Studies link air pollution with diabetes mellitus prevalence, morbidity, and mortality. Pollution affects the immune system and is associated with allergic rhinitis, allergic sensitization, and autoimmunity. It is also associated with osteoporosis and bone fractures, conjunctivitis, dry eye disease, blepharitis, inflammatory bowel disease, increased intravascular coagulation, and decreased glomerular filtration rate. Atopic and urticarial skin disease, acne, and skin aging are linked to air pollution. Air pollution is controllable and, therefore, many of these adverse health effects can be prevented.
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1区Q1影响因子: 8.6
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12. Air Pollution and Noncommunicable Diseases: A Review by the Forum of International Respiratory Societies' Environmental Committee, Part 1: The Damaging Effects of Air Pollution.
Air pollution poses a great environmental risk to health. Outdoor fine particulate matter (particulate matter with an aerodynamic diameter < 2.5 μm) exposure is the fifth leading risk factor for death in the world, accounting for 4.2 million deaths and > 103 million disability-adjusted life years lost according to the Global Burden of Disease Report. The World Health Organization attributes 3.8 million additional deaths to indoor air pollution. Air pollution can harm acutely, usually manifested by respiratory or cardiac symptoms, as well as chronically, potentially affecting every organ in the body. It can cause, complicate, or exacerbate many adverse health conditions. Tissue damage may result directly from pollutant toxicity because fine and ultrafine particles can gain access to organs, or indirectly through systemic inflammatory processes. Susceptibility is partly under genetic and epigenetic regulation. Although air pollution affects people of all regions, ages, and social groups, it is likely to cause greater illness in those with heavy exposure and greater susceptibility. Persons are more vulnerable to air pollution if they have other illnesses or less social support. Harmful effects occur on a continuum of dosage and even at levels below air quality standards previously considered to be safe.
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3区Q2影响因子: 5.8
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13. Population susceptibility differences and effects of air pollution on cardiovascular mortality: epidemiological evidence from a time-series study.
13. 人群易感性差异和空气污染对心血管死亡率的影响:从时间序列研究的流行病学证据。
作者:Liu Mengyao , Xue Xiaoxia , Zhou Baosen , Zhang Yawei , Sun Baijun , Chen Jianping , Li Xuelian
期刊:Environmental science and pollution research international
日期:2019-04-08
DOI :10.1007/s11356-019-04960-2
There is insufficient evidence on the relationship between air pollution and mortality from cardiovascular disease (CVD) in northeast China. Here, we explored the short-term effects of air pollution on CVD mortality and preliminarily investigated differences in population susceptibility to air pollution in Shenyang, China. CVD mortality, air pollution, and meteorological data during 2013-2016 were obtained. Time-series analysis was applied to evaluate the association between air pollution and daily CVD mortality with different lag structures. In the single-pollutant model, each 10 μg/m increase in PM, PM, SO, NO, and O concentrations and 1 mg/m increase in CO concentrations at lag0 (same day) was significantly associated with an increase of 0.40% (95% confidence interval, 0.22-0.59%), 0.26% (0.12-0.40%), 0.43% (0.16-0.70%), 0.90% (0.14-1.67%), 0.76% (0.21-1.32%), and 3.33% (0.97-5.75%), respectively, in overall CVD mortality. Susceptibility to air pollutants was higher among females, elderly people, and ischemic heart disease patients. Furthermore, air pollution effects on CVD mortality were 2-8 times greater during the non-heating period. In conclusion, the air pollutants PM, PM, SO, NO, O, and CO showed significant positive effects on CVD mortality in Shenyang, China. These findings highlight the adverse effects of air pollution and suggest the need for personal protective equipment and reduction of air pollution sources.
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3区Q1影响因子: 4.614
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14. Phenomenological and Thermodynamic Model of Gas Exchanges in the Placenta during Pregnancy: A Case Study of Intoxication of Carbon Monoxide.
14. 怀孕期间胎盘中气体交换的现象学和热力学模型:一氧化碳中毒的案例研究。
期刊:International journal of environmental research and public health
日期:2019-10-27
DOI :10.3390/ijerph16214138
The present work simulates the transport of oxygen, carbon dioxide, and carbon monoxide between a fetus's circulatory system and the mother's. The organ responsible for this exchange is the placenta. Carbon monoxide is a common air pollutant, and it impacts the physiological conditions even in low concentration. The impacts of carbon monoxide are especially dangerous for pregnant women, fetuses, and newborn babies. A model of carbon monoxide transport, from the literature, is modified to simulate a pregnant woman (original model was a male), therefore changing some parameters to express the adjusted respiratory system. It was considered the gas exchange in the placenta, to evaluate the concentration of these different gases in the fetus arterial and venous blood. Three methods of the exergy analysis are implemented for both mother and fetus respiratory systems, aiming at the comparison with the respiratory system of a male adult. The destroyed exergy of the literature did not have the same trend as the models proposed in this article, taking into consideration the hemoglobin reactions. In contrast, the entropy generation associated only with the diffusion transport phenomena was one order of magnitude lower than the other methods. The placenta destroyed exergy rate is significantly higher compared to the irreversibilities of the mother's respiratory system. One possible explanation is the fact that the placenta has other physiological functions than gas transportation.
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1区Q1影响因子: 9.7
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15. Short-term exposure to carbon monoxide and myocardial infarction: A systematic review and meta-analysis.
15. 短期暴露于一氧化碳和心肌梗死:系统审查和荟萃分析。
期刊:Environment international
日期:2020-07-04
DOI :10.1016/j.envint.2020.105901
BACKGROUND:Previous studies suggest an association between short-term exposure to carbon monoxide and myocardial infarction. We performed a systematic review and meta-analysis to assess current evidence on this association to support the update of the World Health Organization (WHO) Global Air Quality Guidelines. METHODS:We searched Medline, Embase and Cochrane Central Register of Controlled Trials to update the evidence published in a previous systematic review up to 30th September 2018 for studies investigating the association between short-term exposure to ambient carbon monoxide (up to lag of seven days) and emergency department visits or hospital admissions and mortality due to myocardial infarction. Two reviewers assessed potentially eligible studies and performed data extraction independently. Random-effects meta-analysis was used to derive the pooled risk estimate per 1 mg/m increase in ambient carbon monoxide concentration. Risk of bias in individual studies was assessed using a domain-based assessment tool. The overall certainty of the body of evidence was evaluated using an adapted certainty of evidence assessment framework. RESULTS:We evaluated 1,038 articles from the previous review and our updated literature search, of which, 26 satisfied our inclusion criteria. Overall, myocardial infarction was associated with exposure to ambient carbon monoxide concentration (risk ratio of 1.052, 95% confidence interval 1.017-1.089 per 1 mg/m increase). A third of studies were assessed to be at high risk of bias (RoB) due to inadequate adjustment for confounding. Using an adaptation of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework, the overall evidence was assessed to be of moderate certainty. CONCLUSIONS:This review demonstrated that the pooled risk ratio for myocardial infarction was 1.052 (95% CI 1.017-1.089) per 1 mg/m increase in ambient carbon monoxide concentration. However, very few studies originated from low- and middle-income countries.
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1区Q1影响因子: 17.1
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16. Maternal Use of Specific Antidepressant Medications During Early Pregnancy and the Risk of Selected Birth Defects.
16. 孕产妇妊娠早期使用的特定的抗抑郁药物和选择的出生缺陷的风险。
期刊:JAMA psychiatry
日期:2020-12-01
DOI :10.1001/jamapsychiatry.2020.2453
Importance:Antidepressants are commonly used during pregnancy, but limited information is available about individual antidepressants and specific birth defect risks. Objective:To examine associations between individual antidepressants and specific birth defects with and without attempts to partially account for potential confounding by underlying conditions. Design, Setting, and Participants:The population-based, multicenter case-control National Birth Defects Prevention Study (October 1997-December 2011) included cases with selected birth defects who were identified from surveillance systems; controls were randomly sampled live-born infants without major birth defects. Mothers of cases and controls participated in an interview after the expected delivery date. The data were analyzed after the completion of the National Birth Defects Prevent Study's data collection. Exposures:Self-reported antidepressant exposure was coded to indicate monotherapy exposure to antidepressants. Main Outcomes and Measures:We used multivariable logistic regression to calculate adjusted odds ratios (aORs) and 95% confidence intervals for associations between maternal antidepressant use and birth defects. We compared early pregnancy antidepressant-exposed women with those without antidepressant exposure and, to partially account for confounding by underlying maternal conditions, those exposed to antidepressants outside of the birth defect development critical period. Results:This study included 30 630 case mothers of infants with birth defects and 11 478 control mothers (aged 12-53 years). Early pregnancy antidepressant use was reported by 1562 case mothers (5.1%) and 467 control mothers (4.1%), for whom elevated aORs were observed for individual selective serotonin reuptake inhibitors (SSRIs) and selected congenital heart defects (CHD) (eg, fluoxetine and anomalous pulmonary venous return: aOR, 2.56; 95% CI, 1.10-5.93; this association was attenuated after partially accounting for underlying conditions: aOR, 1.89; 95% CI, 0.56-6.42). This pattern was observed for many SSRI-CHD combinations. Associations between SSRIs and non-CHD birth defects often persisted or strengthened after partially accounting for underlying conditions (eg, citalopram and diaphragmatic hernia: aOR, 5.11; 95% CI, 1.29-20.24). Venlafaxine had elevated associations with multiple defects that persisted after partially accounting for underlying conditions (eg, anencephaly and craniorachischisis: aOR, 9.14; 95% CI, 1.91-43.83). Conclusions and Relevance:We found some associations between maternal antidepressant use and specific birth defects. Venlafaxine was associated with the highest number of defects, which needs confirmation given the limited literature on venlafaxine use during pregnancy and risk for birth defects. Our results suggest confounding by underlying conditions should be considered when assessing risk. Fully informed treatment decision-making requires balancing the risks and benefits of proposed interventions against those of untreated depression or anxiety.
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2区Q1影响因子: 8.1
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17. Maternal air pollution exposure and congenital heart defects in offspring: A systematic review and meta-analysis.
17. 孕妇空气污染和后代先天性心脏缺陷:系统评价和荟萃分析。
作者:Hu Cheng-Yang , Huang Kai , Fang Yuan , Yang Xiao-Jing , Ding Kun , Jiang Wen , Hua Xiao-Guo , Huang Da-Yan , Jiang Zheng-Xuan , Zhang Xiu-Jun
期刊:Chemosphere
日期:2020-04-06
DOI :10.1016/j.chemosphere.2020.126668
BACKGROUND:Congenital heart defects (CHDs) has a multifactorial causation with a strong genetic component and many environmental triggers. Emerging body of empirical studies suggest that air pollution is an important contributor to the development of CHDs, however, there still remains some controversy over the current evidence, and to the authors' knowledge, no studies have reviewed the most recent evidence. OBJECTIVES:We performed a systematic review and meta-analysis of epidemiological literature to investigate the relationship between maternal air pollution exposure and CHDs risk in offspring. The presence of heterogeneity and publication bias across available studies were also examined. METHODS:An extensive literature search of epidemiological studies pertaining to air pollution and CHDs, published in English language, until August 1, 2019 was conducted. Summary risk estimates of pollution-outcome combinations were calculated for i) risk per specific increment of concentration and ii) risk at high versus low exposure level in each study using fixed-effect model or random-effects model. RESULTS:A total of 26 studies were finally included. In the meta-analyses, high versus low carbon monoxide (CO) exposure was associated with an increased risk of tetralogy of Fallot [odds ratio (OR) = 1.21, 95% confidence interval (CI): 1.04-1.41], yet particulate matter ≤ 5 μm (PM) exposure was marginally associated with it. Increased risk of atrial septal defects (ASDs) was found for each 10 μg/m and 10 ppb increment in particulate matter ≤ 10 μm (PM) and ozone (O) exposure, respectively (OR = 1.04, 95% CI: 1.00-1.09; OR = 1.09, 95% CI: 1.02-1.17). Categorical nitrogen dioxide (NO) exposure was associated with an increased risk of coarctation of the aorta (OR for high versus low = 1.14, 95% CI: 1.02-1.26). Analyses for other combinations yielded none statistically significant associations. Sensitive analyses showed similar findings. CONCLUSIONS:The summary effect estimates from this study suggest statistically significant associations between increased risk of specific CHDs subtypes and PM, PM, NO, CO, and O exposures. Further studies, especially conducted in developing countries, with improvements in exposure assessing, outcome harmonizing, and mechanistic understanding are needed to elaborate the suggestive associations.
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2区Q1影响因子: 7.3
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18. Air pollution and hospital admissions for respiratory diseases in Lanzhou, China.
18. 空气污染和兰州,中国呼吸系统疾病入院。
作者:Tao Yan , Mi Shengquan , Zhou Shuhong , Wang Shigong , Xie Xiaoyun
Lanzhou is among the most seriously air-polluted cities in China as a whole, due to its unique topography, climate, industrial structure and so on. We studied the relationship between different air pollution and respiratory hospitalizations from 2001 to 2005, the total of respiratory hospital admissions were 28,057. The data were analyzed using Poisson regression models after controlling for the long time trend for air pollutants, the "day of week" effect and confounding meteorological factors. Three air pollutants (PM10, SO2, NO2) had a lag effect, the lag was 3-5 days for PM10, 1-3 days for SO2 and 1-4 days for NO2. The relative risks were calculated for increases in the inter-quartile range of the pollutants (139 μg/m(3) in PM10, 61 μg/m(3) in SO2 and 31 μg/m(3) in NO2). Results showed that there were significant associations between air pollutants and respiratory hospital admissions, and stronger effects were observed for females and aged ≥65 yrs in Lanzhou.
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2区Q1影响因子: 7.7
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19. Maternal exposure to traffic-related air pollution and birth defects in Massachusetts.
19. 孕产妇在马萨诸塞州的交通相关空气污染和先天缺陷中的暴露。
作者:Girguis Mariam S , Strickland Matthew J , Hu Xuefei , Liu Yang , Bartell Scott M , Vieira Verónica M
期刊:Environmental research
日期:2015-12-17
DOI :10.1016/j.envres.2015.12.010
Exposures to particulate matter with diameter of 2.5µm or less (PM2.5) may influence risk of birth defects. We estimated associations between maternal exposure to prenatal traffic-related air pollution and risk of cardiac, orofacial, and neural tube defects among Massachusetts births conceived 2001 through 2008. Our analyses included 2729 cardiac, 255 neural tube, and 729 orofacial defects. We used satellite remote sensing, meteorological and land use data to assess PM2.5 and traffic-related exposures (distance to roads and traffic density) at geocoded birth addresses. We calculated adjusted odds ratios (OR) and confidence intervals (CI) using logistic regression models. Generalized additive models were used to assess spatial patterns of birth defect risk. There were positive but non-significant associations for a 10µg/m(3) increase in PM2.5 and perimembranous ventricular septal defects (OR=1.34, 95% CI: 0.98, 1.83), patent foramen ovale (OR=1.19, 95% CI: 0.92, 1.54) and patent ductus arteriosus (OR=1.20, 95% CI: 0.95, 1.62). There was a non-significant inverse association between PM2.5 and cleft lip with or without palate (OR=0.76, 95% CI: 0.50, 1.10), cleft palate only (OR=0.89, 95% CI: 0.54, 1.46) and neural tube defects (OR=0.77, 95% CI: 0.46, 1.05). Results for traffic related exposure were similar. Only ostium secundum atrial septal defects displayed significant spatial variation after accounting for known risk factors.
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2区Q1影响因子: 5.6
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20. Ambient air pollution and congenital heart defects in Lanzhou, China.
20. 中国兰州的环境空气污染和先天性心脏缺陷。
作者:Jin Lan , Qiu Jie , Zhang Yaqun , Qiu Weitao , He Xiaochun , Wang Yixuan , Sun Qingmei , Li Min , Zhao Nan , Cui Hongmei , Liu Sufen , Tang Zhongfeng , Chen Ya , Yue Li , Da Zhenqiang , Xu Xiaoying , Huang Huang , Liu Qing , Bell Michelle L , Zhang Yawei
期刊:Environmental research letters : ERL [Web site]
日期:2015-07-08
DOI :10.1088/1748-9326/10/7/074005
Congenital heart defects are the most prevalent type of birth defects. The association of air pollution with congenital heart defects is not well understood. We investigated a cohort of 8,969 singleton live births in Lanzhou, China during 2010-2012. Using inverse distance weighting, maternal exposures to particulate matter with diameter ≤10 (PM), nitrogen dioxide (NO), and sulfur dioxide (SO) were estimated as a combination of monitoring station levels for the time spent at home and the work location. We used logistic regression to estimate the associations, adjusting for maternal age, education, income, BMI, disease, folic acid intake and therapeutic drug use, and smoking; season of conception; fuels for cooking; and temperature. We found significant positive associations of Patent Ductus Arteriosus (PDA) with PM during the 1 trimester, 2 trimester and the entire pregnancy (OR =3.96, 95% Confidence Interval (CI): 1.36, 11.53; OR =3.59, 95% Confidence Interval (CI): 1.57, 8.22; OR =2.09, 95% CI: 1.21, 3.62, per interquartile range (IQR) increment for PM (IQR=71.2, 61.6, and 27.4 μg/m respectively)), and associations with NO during 2 trimester and entire pregnancy (OR = 1.92, 95% CI: 1.11, 3.34; OR =2.32, 95% Cl: 1.14, 4.71, per IQR increment for NO (IQR=13.4 and 10.9 μg/m respectively)). The associations for congenital malformations of the great arteries and pooled cases showed consistent patterns. We also found positive associations for congenital malformations of cardiac septa with PM exposures in the 2 trimester and the entire pregnancy, and SO exposures in the entire pregnancy. Results indicate a health burden from maternal exposures to air pollution, with increased risk of congenital heart defects.
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21. Addressing the rising burden of congenital heart disease in China.
21. 解决中国先天性心脏病日益严重的负担。
作者:He Yihua , Xu Weize , Su Zhanhao , Liu Kaibo , Zhang Hao
期刊:The Lancet. Child & adolescent health
日期:2020-03-17
DOI :10.1016/S2352-4642(20)30061-4
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22. Ascertaining the Burden of Birth Defects.
22. 确定出生缺陷的负担。
期刊:American journal of preventive medicine
日期:2016-05-01
DOI :10.1016/j.amepre.2016.02.003
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23. Global birth prevalence of congenital heart defects 1970-2017: updated systematic review and meta-analysis of 260 studies.
23. 全球出生先天性心脏病患病率1970 - 2017:260更新的系统回顾和荟萃分析的研究。
期刊:International journal of epidemiology
日期:2019-04-01
DOI :10.1093/ije/dyz009
BACKGROUND:Globally, access to healthcare and diagnostic technologies are known to substantially impact the reported birth prevalence of congenital heart disease (CHD). Previous studies have shown marked heterogeneity between different regions, with a suggestion that CHD prevalence is rising globally, but the degree to which this reflects differences due to environmental or genetic risk factors, as opposed to improved detection, is uncertain. We performed an updated systematic review to address these issues. METHODS:Studies reporting the birth prevalence of CHD between the years 1970-2017 were identified from searches of PubMed, EMBASE, Web of Science and Google Scholar. Data on the prevalence of total CHD and 27 anatomical subtypes of CHD were collected. Data were combined using random-effect models. Subgroup and meta-regression analyses were conducted, focused on geographical regions and levels of national income. RESULTS:Two hundred and sixty studies met the inclusion criteria, encompassing 130 758 851 live births. The birth prevalence of CHD from 1970-2017 progressively increased to a maximum in the period 2010-17 of 9.410/1000 [95% CI (confidence interval) 8.602-10.253]. This represented a significant increase over the fifteen prior years (P = 0.031). The change in prevalence of mild CHD lesions (ventricular septal defect, atrial septal defect and patent ductus arteriosus) together explained 93.4% of the increased overall prevalence, consistent with a major role of improved postnatal detection of less severe lesions. In contrast the prevalence of lesions grouped together as left ventricular outflow tract obstruction (which includes hypoplastic left heart syndrome) decreased from 0.689/1000 (95% CI 0.607-0.776) in 1995-99, to 0.475/1000 (95% CI 0.392-0.565; P = 0.004) in 2010-17, which would be consistent with improved prenatal detection and consequent termination of pregnancy when these very severe lesions are discovered. There was marked heterogeneity among geographical regions, with Africa reporting the lowest prevalence [2.315/1000 (95% CI 0.429-5.696)] and Asia the highest [9.342/1000 (95% CI 8.072-10.704)]. CONCLUSIONS:The reported prevalence of CHD globally continues to increase, with evidence of severe unmet diagnostic need in Africa. The recent prevalence of CHD in Asia for the first time appears higher than in Europe and America, where disease ascertainment is likely to be near-complete, suggesting higher genetic or environmental susceptibility to CHD among Asian people.
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2区Q1影响因子: 5.9
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24. Maternal proximity to extremely low frequency electromagnetic fields and risk of birth defects.
24. 产妇接近极低频电磁场与出生缺陷的风险。
作者:Auger Nathalie , Arbour Laura , Luo Wei , Lee Ga Eun , Bilodeau-Bertrand Marianne , Kosatsky Tom
期刊:European journal of epidemiology
日期:2019-04-11
DOI :10.1007/s10654-019-00518-1
Causes of birth defects are unclear, and the association with electromagnetic fields is inconclusive. We assessed the relationship between residential proximity to extremely low frequency electromagnetic fields from power grids and risk of birth defects. We analyzed a population-based sample of 2,164,246 infants born in Quebec, Canada between 1989 and 2016. We geocoded the maternal residential postal code at delivery and computed the distance to the nearest high voltage electrical transmission line or transformer station. We used log-binomial regression to estimate risk ratios (RR) and 95% confidence intervals (CI) for the association of residential proximity to transmission lines and transformer stations with birth defects, adjusting for maternal and infant characteristics. The prevalence of birth defects within 200 m of a transmission line (579.4 per 10,000 per live births) was only slightly higher compared with distances further away (568.7 per 10,000). A similar trend was seen for transformer stations. Compared with 200 m, a distance of 50 m was not associated with the risk of birth defects for transmission lines (RR 1.00, 95% CI 1.00-1.01) and transformer stations (RR 1.01, 95% CI 1.00-1.03). There was no consistent association when we examined birth defects in different organ systems. We found no compelling evidence that residential proximity to extremely low frequency electromagnetic fields from electrical power grids increases the risk of birth defects. Women residing near electrical grids can be reassured that an effect on the risk of birth defects is unlikely.
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25. Birth prevalence of congenital heart disease in China, 1980-2019: a systematic review and meta-analysis of 617 studies.
25. 1980 - 2019 年中国先天性心脏病出生患病率:对 617 项研究的系统回顾与 meta 分析。
期刊:European journal of epidemiology
日期:2020-06-09
DOI :10.1007/s10654-020-00653-0
To assess the birth prevalence and spatial distribution of congenital heart disease (CHD) in China by conducting a complete overview and using spatial epidemiological methods. Unrestricted searches were conducted on seven electronic databases, with an end-date parameter of May 2019. Data on the birth prevalence of CHD and its subtypes were collected and combined using either the random-effect model or fixed-effect model. Subgroup sensitivity analyses were performed to explore potential heterogeneity moderators. The three-dimensional trend analysis and a visualization of CHD birth prevalence among different provinces were performed to describe the spatial distribution characteristics. Total 617 studies involving 76,961,354 births and 201,934 CHD individuals were included. Overall, total CHD birth prevalence increased continuously over time, from 0.201‰ in 1980-1984 to 4.905‰ in 2015-2019. The study on the high-income provinces, population-based monitoring model, male births, and urban regions reported a significantly higher prevalence of total CHD compared with upper-middle-income provinces, hospital-based monitoring model, female births, and rural regions, respectively. National CHD birth prevalence increased gradually from western region to eastern region, but decreased gradually from southern to northern region. Relevant heterogeneity moderators including gender, geographic region, income levels, and monitoring models have been identified by subgroup analyses. Sensitivity analysis yielded consistent results. Total CHD birth prevalence in China increases continuously in the past 40 years. Significant differences in gender, geographical regions, income levels, and monitoring models were found. In the future, population wide prospective birth defect registries covering the entire Chinese population need to determine the exact birth prevalence.