The broad, long term objective of this award is to facilitate independence as a nurse scientist, generate preliminary evidence and facilitate an R01 application. The overarching goal of this study is to compare vascular function, cardiac structure and function and lipid biomarker/fibrosis proteomics between each adverse pregnancy group to gain insight into mechanisms leading to adverse outcomes and provide opportunities for intervention. The proposed study, ?Is Preeclampsia and Spontaneous Preterm Delivery Associated with Vascular and Cardiac Dysfunction?? is a longitudinal, comparative design study, were I will compare 4 groups; 1) women who experience term preeclampsia (?37 weeks); 2) spontaneous preterm delivery (sPTD) (? 34 weeks) and; 3) preterm preeclampsia (PreE) (<37 weeks) compared to women who experience 4) full-term deliveries (?39 weeks) at 3-time points (24-72 hours, 1 and 2 years postpartum). My long-term goals are to: (1) employ comprehensive mechanistic phenotyping and utilizing cardiac magnetic resonance imaging (CMRI) techniques to refine the current understanding of mechanisms linking adverse pregnancy outcomes (APOs) and atherosclerotic cardiovascular disease (ASCVD) risk; (2) translate scientific advances across cardiovascular, nursing science, proteomics and women?s health research in order to elucidate how we further phenotype APOs (3) enhance our ability to identify individuals at risk for future ASCVD early in the course of ASCVD, before the onset of clinical disease; (4) ultimately change ASCVD disease course for women who are at increased risk (5) lead a multidisciplinary team of translational investigators focused on the research. The following key variables related to future risk of cardiovascular disease will be evaluated: vascular function (augmentation index and pulse wave velocity) and cardiac structure and function measured by cardiac magnetic resonance imaging utilizing Cine, Tissue Tagging (left ventricular systolic and diastolic function including strain), T1 mapping (fibrosis), at 1 and 2 years postpartum.) Secondary measures include novel cardiac biomarkers including a lipid biomarker collection for 72 proteins and lipids, proteomics fibrosis panel [(Matric metalloproteinases (MMPs) and Transforming Growth Factor-?1 (TGF-?1). Ultimately, the outcome of this research will inform relationships between TPre, sPTD and PreE which is an important step to uncover the link between APOs and future maternal ASCVD risk. This effort will shape the development of specific treatment targets for new opportunities in chronic ASCVD prevention. Achieved training goals will augment and facilitate independence, generate preliminary evidence and facilitate an R01 application.
This new application for Margo Minissian, PhD, ACNP incorporates a multi-disciplinary, mentored patient- oriented research plan to facilitate independence as a nurse scientist, generate preliminary evidence and facilitate an R01 application. This comparative, longitudinal study will compare vascular and cardiac structure/ function and novel cardiac biomarkers in mothers who had term preeclampsia (TPre), spontaneous preterm delivery (sPTD) and preterm preeclampsia (PreE) compared to full-term controls. The outcome of this research will inform relationships between TPre, sPTD and PreE which is an important step to uncover the link between adverse pregnancy outcomes and future maternal atherosclerotic cardiovascular disease (ASCVD) risk.