Journal
FETAL DIAGNOSIS AND THERAPY
Volume 47, Issue 5, Pages 337-344Publisher
KARGER
DOI: 10.1159/000506047
Keywords
Fetal heart; Prenatal development; Intrauterine growth restriction; Assisted reproductive technologies; Congenital heart disease; Echocardiography
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Funding
- Erasmus+ Programme of the European Union [2013-0040]
- la Caixa Foundation [LCF/PR/GN14/10270005]
- Instituto de Salud Carlos III [PI15/00130, PI15/00263, PI17/00675, PI18/00073]
- Centro de Investigacion Biomedica en Red de Enfermedades Raras [ERPR04G719/2016]
- Cerebra Foundation for the Brain Injured Child (Carmarthen, Wales, UK)
- AGAUR 2017 SGR grant [1531]
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The heart is a central organ in the fetal adaptation to an adverse environment. Fetal cardiac changes may persist postnatally and increase the risk of cardiovascular disease in adulthood. Knowledge about fetal cardiac structural as well as functional remodeling has radically improved over the last few years. As it occurs in postnatal life, the fetal heart remodels - changing its structure and shape - to adapt to an insult. Several conditions have been reported to be associated with fetal cardiac remodeling including intrauterine growth restriction, diabetes, exposure to antiretroviral drugs, conception by assisted reproductive technologies, pulmonary stenosis, and other congenital heart diseases. Here we summarized the main observable patterns of cardiac remodeling, i.e., globular shape, hypertrophy without dilation, and hypertrophy with cardiomegaly. We discuss the potential pathophysiology behind different types of remodeling. Defining precisely the distinct patterns of fetal cardiac remodeling is critical for advancing in the understanding of fetal cardiovascular programming and its consequences on adult health, and potentially for the design of preventive strategies that might have an impact on long-term cardiovascular health.
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