Assisted Reproductive Technologies Are Associated With Cardiovascular Remodeling In Utero That Persists Postnatally
2013
Background—Assisted reproductive technologies (ARTs) have been shown to be associated with general vascular dysfunction in late childhood. However, it is unknown whether cardiac remodeling is also present and if these changes already manifest in prenatal life. Our aim was to assess fetal and infant (6 months of age) cardiovascular function in ART pregnancies. Methods and Results—This prospective cohort study included 100 fetuses conceived by ART and 100 control pregnancies. ART fetuses showed signs of cardiovascular remodeling, including a more globular heart with thicker myocardial walls, decreased longitudinal function (tricuspid ring displacement in controls: median, 6.5 mm [interquartile range, 6.1–7.1 mm]; tricuspid ring displacement in ART: 5.5 mm [interquartile range, 5.1–6.1]; P<0.001), impaired relaxation, and dilated atria (atrial area in controls, 1.46 cm2 [interquartile range, 1.2–1.5 cm2]; atrial area in ART, 1.6 cm2 [interquartile range, 1.3–1.8 cm2]; P<0.001). Additionally, ART infants show...
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