Cardiac dysfunction is associated with altered sarcomere ultrastructure in intrauterine growth restriction.
OBJECTIVE
The purpose of this study was to assess whether abnormal cardiac function in human fetuses with intrauterine growth restriction (IUGR) is associated with ultrastructural differences in the cardiomyocyte sarcomere.


METHODS
Nine severe early-onset IUGR fetuses and 9 normally grown fetuses (appropriate growth for gestational age) who died in the perinatal period were included prospectively. Cardiac function was assessed by echocardiography and levels of B-type natriuretic peptide and troponin-I. Heart sections were imaged by second harmonic generation microscopy, which allowed unstained visualization of cardiomyocyte's sarcomere length.


RESULTS
Echocardiographic and biochemical markers showed signs of severe cardiac dysfunction in IUGR fetuses. Second harmonic generation microscopy demonstrated a significantly shorter sarcomere length in IUGR as compared with appropriate growth for gestational age fetuses.


CONCLUSIONS
IUGR is associated with changes in the cardiomyocyte contractile machinery in the form of shorter sarcomere length, which could help to explain the cardiac dysfunction previously documented in IUGR.
Fetal and Perinatal Medicine Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Maternal-Fetal Medicine, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain.
Jesus Igor
JI
Iruretagoyena
Fetal and Perinatal Medicine Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Anna
A
Gonzalez-Tendero
Fetal and Perinatal Medicine Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Physense, Departament de Tecnologies de la Informació i les Comunicacions (DTIC), Universitat Pompeu Fabra, Barcelona, Spain.
Patricia
P
Garcia-Canadilla
Fetal and Perinatal Medicine Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Ivan
I
Amat-Roldan
Fetal and Perinatal Medicine Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Iratxe
I
Torre
Department of Pathology, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain.
Alfons
A
Nadal
Fetal and Perinatal Medicine Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Maternal-Fetal Medicine, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain.
Fatima
F
Crispi
Fetal and Perinatal Medicine Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Maternal-Fetal Medicine, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain. Electronic address: gratacos@clinic.ub.es.
Eduard
E
Gratacos
D016022:Case-Control Studies; D004452:Echocardiography; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D005333:Fetus / Q000503:physiopathology*; D005865:Gestational Age; D006801:Humans; D032383:Myocytes, Cardiac / Q000648:ultrastructure*; D020097:Natriuretic Peptide, Brain / Q000032:analysis*; D011247:Pregnancy; D012518:Sarcomeres / Q000648:ultrastructure*; D019210:Troponin I / Q000032:analysis*; D016216:Ultrasonography, Prenatal
D019210:Troponin I; D020097:Natriuretic Peptide, Brain
cardiac function; cardiomyocyte; intrauterine growth restriction; sarcomere; second harmonic generation microscopy