Review

The Placenta is a Programming Agent for Cardiovascular Disease

Kent Thornburg, P. F. O'Tierney, Samantha Louey

    Research output: Contribution to journalArticle

    128 Citations (Scopus)

    Abstract

    Cardiovascular disease remains the number one killer in western nations in spite of declines in death rates following improvements in clinical care. It has been 20 years since David Barker and colleagues showed that slow rates of prenatal growth predict mortality from ischemic heart disease. Thus, fetal undergrowth and its associated cardiovascular diseases must be due, in part, to placental inadequacies. This conclusion is supported by a number of studies linking placental characteristics with various adult diseases. A "U" shaped relationship between placental-to-fetal weight ratio and heart disease provides powerful evidence that placental growth-regulating processes initiate vulnerabilities for later heart disease in offspring. Recent evidence from Finland indicates that placental morphological characteristics predict risks for coronary artery disease, heart failure, hypertension and several cancers. The level of risk imparted by placental shape is sex dependent. Further, maternal diet and body composition strongly influence placental growth, levels of inflammation, nutrient transport capacity and oxidative stress, with subsequent effects on offspring health. Several animal models have demonstrated the placental roots of vulnerability for heart disease. These include findings that abnormal endothelial development in the placenta is associated with undergrown myocardial walls in the embryo, and that placental insufficiency leads to depressed maturation and proliferation of working cardiomyocytes in the fetal heart. Together these models suggest that the ultimate fitness of the heart is determined by hemodynamic, growth factor, and oxygen/nutrient cues before birth, all of which are influenced, if not regulated by the placenta.

    Original languageEnglish (US)
    JournalPlacenta
    Volume31
    Issue numberSUPPL.
    DOIs
    StatePublished - Mar 2010

    Fingerprint

    Placenta
    Fetal Heart
    Heart Diseases
    Cardiovascular Diseases
    Growth
    Placental Insufficiency
    Food
    Fetal Weight
    Mortality
    Finland
    Body Composition
    Cardiac Myocytes
    Myocardial Ischemia
    Cues
    Coronary Artery Disease
    Intercellular Signaling Peptides and Proteins
    Oxidative Stress
    Embryonic Structures
    Animal Models
    Heart Failure

    Keywords

    • Heart development
    • Heart disease
    • Hypertension
    • Nutrition
    • Placenta
    • Programming

    ASJC Scopus subject areas

    • Obstetrics and Gynecology
    • Reproductive Medicine
    • Developmental Biology

    Cite this

    Review : The Placenta is a Programming Agent for Cardiovascular Disease. / Thornburg, Kent; O'Tierney, P. F.; Louey, Samantha.

    In: Placenta, Vol. 31, No. SUPPL., 03.2010.

    Research output: Contribution to journalArticle

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