Nipah Virus and Bacteria Infections: Cardiac Complications in Maternal Health

Gestational Diabetes and Complications

According to the Gunderson et al study, Black and White women without a history of gestational diabetes who developed impaired glucose tolerance or overt diabetes within 15 years of giving birth had a progressively higher relative risk of coronary artery calcification in middle age (1.5- to 2.2-fold) compared to women who maintained normoglycemia. Women with normoglycemia, impaired glucose tolerance (prediabetes), or overt diabetes within 15 years of pregnancy had a relative risk of coronary artery calcification in midlife that was two times higher than women without a history of gestational diabetes who maintained normoglycemia. Maintaining normoglycemia may not reduce the risk of atherosclerotic cardiovascular disease in women who have had gestational diabetes in the past. Through routes including insulin resistance and decreased insulin secretion that promote atherogenic plaques independent of dysglycemia, a history of gestational diabetes may include underlying vascular alterations and negatively affect the development of cardiovascular disease. These results add to the accumulating evidence that better risk stratification of women for the early prevention of atherosclerotic cardiovascular disease is required among those with a history of gestational diabetes [4].

According to the Lane-Cordova et al study, Preterm birth or a small-for-gestational-age infant in the past increased the risk of atherosclerotic cardiovascular disease (ASCVD) in late middle age and increased the likelihood that a woman would experience significant vasomotor symptoms of menopause. In adjusted analyses of white women, a history of a preterm birth/small for gestational age infant and vasomotor symptoms were linked to an increased risk of ASCVD compared to no exposures. Women were more likely to have ASCVD risk scores below 7.5% if they also had vasomotor signs of menopause, preterm birth, or a small for gestational age child. The risk of ASCVD later in life was linked to reproductive events across the life course, particularly in white women. To better assess ASCVD risk, clinicians should ask patients about their complete reproductive history, including information on pregnancy and menopause [5].

When a woman enters menopause, her periods (menstruation) cease. Most frequently, it is a typical, natural body transformation that happens between the ages of 45 and 55. A woman can no longer get pregnant after menopause. A chronic infection of the heart’s lining or valves that is largely bacterial in origin and can either be culture-positive or culture-negative is known as infectious endocarditis (IE). IE has been linked to Staphylococcus and Streptococcus species most frequently. However, reports of IE being caused by other rare organisms like nutritionally variant Streptococcus, Bartonella spp., Coxiella burnetii, Trophyrema whippelii, HACEK (Haemophilus aphrophilus, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, Kingella kingae) group and some of the fungi are on a rise. Rare organisms such Abiotrophia defectiva, Gemella, Finegoldia, Propionibacterium humerusii, and Haemophilus parainfluenzae have also been the cause of sporadic cases that have been documented in the literature Yallowitz, et al. [6]. The cardiovascular system can be impacted by a wide variety of infectious pathogens, including those that can develop spontaneous epidemics or spread through biological attack. Numerous of these infectious diseases have been present in specific regions of the world for millennia, either sporadically (e.g., botulism, tularemia) or endemically (e.g., viral hemorrhagic fevers), while others are relatively recent introductions (e.g., severe acute respiratory syndrome, or SARS, or Nipah virus) [7].

Potential Obstacles to  Successful Clinical Application

Cardiomyocytes can be produced effectively and repeatedly from induced pluripotent stem cell (iPSC) technology thanks to recent advancements [8]. For the following reasons, using iPSCs in cell therapy is highly appealing. First, the vast self-renewal and differentiation capability of iPSCs enables the production of a significant quantity of the iPSC-derived cardiomyocytes (iPSC- CMs) necessary for a successful cell treatment. Second, because iPSCs are capable of self-renewal, desired genetic modifications can be made to them before differentiation [9]. Third, iPSC-CMs demonstrate beating cardiomyocyte characteristics, and it has been demonstrated that they engraft in the host heart and electromechanically pair to nearby native cardiomyocytes [10]. The adoption of allogenic iPSC-CMs may also assist avoid any potential immunogenicity of the transplanted cells because iPSCs are created from the somatic cells of the patient [11]. Zhu, et al.’s observation of ongoing myocardial regeneration in iPSC-CMs provides more evidence for the long-lasting efficiency of genetically engineered cell cycle activation. Although more investigation is required to fully comprehend the long-term implications of CCND2 overexpression in iPSC-CMs, Zhu et al.’s method of genetically resetting cardiac cell cycle activity appears to be a promising method for effective myocardial regeneration [12]. In a nonhuman primate model employing pigs, Mattapally et al. recently described allogeneic transplantation of iPSC- CMs. Although they saw the transplanted iPSC-CMs engraft successfully, recipient pigs experienced brief episodes of ventricular tachycardia [13].