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Early-life Determinants of Cardiovascular Disease

Prof. Tiago Henriques Coelho
Group Leader

This research group is dedicated not only to foetal and paediatric cardiovascular disease (CVD), but also to the study of the impact of maternal, foetal and neonatal/paediatric factors in adolescent and young adult CVD. The Group is led by Henriques-Coelho, a highly-motivated young clinician with a strong background on basic, translational and clinical research. He finished his PhD within our Centre and has already an enviable academic and clinical curriculum. The group is further composed by clinical researchers some of whom also have a background on basic and translational research. This group of coordinating researchers is strongly supported by their research teams and by colleagues from the clinical departments of Obstetrics and Paediatrics from Centro Hospitalar São João, the busiest hospital in the North of Portugal and a tertiary care centre for Obstetrics and all Paediatrics subspecialties, including a Neonatology Intensive Care Unit that is the main centre for congenital malformations and congenital heart disease (CHD). Also, experimental approaches in animal models of PH and growth restriction are continuously being fostered by the Basic and Translational Research in Cardiovascular Disease Group. Finally, this group maintain a solid collaboration with the Epidemiology group from the former unit assessing two big population cohorts of 8-9 year-old children (Geração XXI) and young 21-22 year-old adults (EpiTeen).

According to Barker’s hypothesis that related impaired growth in utero to cardiovascular risk, we hypothesize that various adverse prenatal conditions, such as low birth weight (LBW), and maternal cardiovascular risk factors (diabetes, hypertension and obesity) accelerate vascular aging and endothelial dysfunction. Other increasingly concerning topics are: (i) cardiovascular risk factors in otherwise healthy children and their impact in adolescent/adult quality of life (QOL), (ii) LBW as a risk factor for CVD and impaired QOL, and (iii) validation of biomarkers such as natriuretic peptides, myocardial enzymes and angiogenesis factors as adjuncts to echocardiography in assessing myocardial compromise and prognosis in new-borns with CHD. Advances in CHD patient care generated a group of adolescent and adult patients with treated CHD that now pose a particular challenge to paediatricians, cardiologists and cardiac surgeons. RV function is crucial in unrepaired or repaired CHD. Identifying early markers of dysfunction and new therapeutic targets is needed and thus this group investigates novel biomarkers in our paediatric and adolescent PH patients. An additional aim of this team is to evaluate in CHD the impact of repaired and residual defects in the QOL of adolescents is warranted. Further studies are under way in order to optimize strategies to improve QOL in this patient population. Finally, as concerns prenatal research, assessing the foetal circulation is cornerstone to understand foetal physiology. Our obstetrics department is internationally renowned for applying early echography markers of foetal cardiac abnormalities such as nuchal translucency and ductus venosus waveform to unveil the pathophysiology of foetal disease and as a tool for screening cardiac impairment in utero, which poses a challenge for the obstetrician and paediatric cardiologist.