Peripartum cardiomyopathy is a specific cardiomyopathy in which heart failure develops during pregnancy or in the postpartum period in women without a history of cardiomyopathy, and reduced myocardial contraction is found on examination. Advanced age, hypertensive disorders in pregnancy (HDP) and multiple conception are well-known risk factors. Since symptoms of heart failure, including shortness of breath and excessive edema, are also frequent in healthy pregnant and parturient women, diagnosis is likely to be delayed. However, it should be included in differential diagnosis for pregnant and postpartum women who complain of those symptoms, especially with risk factors, because it may lead to maternal death in severe cases. Basic studies in animal models have recently been reported, and an association between vascular disorders, such as HDP, and peripartum cardiomyopathy is currently attracting attention. Genetic analyses also revealed the overlap between peripartum cardiomyopathy and familial dilated cardiomyopathy. Special caution is needed in heart failure therapy for pregnant women. Anti-prolactin therapy has been proposed as a novel treatment, based on the theory that cleaved prolactin is a cause of the disease.

View full abstract

In a diagnosis of neonatal congenital heart disease, transthoracic echocardiography is the method of first choice. We can perform the repeated transthoracic echocardiography noninvasively. " Serial axial view scan " is a neonatal echocardiographic method to scan axial images from subcostal abdomen to suprasternal notch continually like computed tomography. Using this method, it is easy to obtain a segmental diagnosis of the congenital heart disease and is superior in the reproducibility of the diagnosis from saved images. The probe operation is relatively easy, but knowledge and a lot of experience with congenital heart disease are necessary for a diagnosis. By the repeated neonatal echocardiography in the neonate with congenital heart disease, we can also observe the change of circulatory dynamics from fetal circulation to neonatal circulation over time. Within the cardiac ability of the neonate with congenital heart disease, we manage the balance between systemic and pulmonary circulation, and devise to preserve the systemic circulation for survival without critical hypoxemia.

View full abstract

Occlusal disharmony causes chronic stress and leads to sympathetic nerve activity. Various types of chronic stress are associated with increased incidence of cardiovascular disease, but the relationship between occlusal disharmony and cardiovascular disease remains poorly understood. Therefore, in this work, we examined the effects of occlusal disharmony on cardiac function in (BO, bite-opening) mice, in which a 0.7 mm space was introduced by cementing a suitable appliance onto the mandibular incisors. Cardiac function was significantly decreased in the BO group compared to the control group. Cardiac fibrosis and myocyte oxidative DNA damage were significantly increased in the BO group. The BO-induced cardiac dysfunction was associated with increased Bax/Bcl-2 ratio and phospholamban phosphorylation at threonine-17 and serine-16, as well as activation of calmodulin kinase II signaling. These data suggest that occlusal disharmony might cause sympathetic nerve activity in the heart, leading to cardiac remodeling and dysfunction.

View full abstract