# Placental Senescence in Peripartum Cardiomyopathy

> **NIH NIH R01** · MASSACHUSETTS GENERAL HOSPITAL · 2024 · $457,978

## Abstract

PROJECT SUMMARY/ABSTRACT
Peripartum cardiomyopathy (PPCM) is a rare form of heart failure (HF) that occurs in women during late
pregnancy to the early postpartum period. Although PPCM incidence is increasing, the etiology of this syndrome
remains unclear and limited treatments are available. A “2-hit” mechanism— in which 1) an unrecognized genetic
predisposition for HF is unmasked by 2) a surge of deleterious circulating factors in late pregnancy—is the
leading hypothesis in PPCM. A fundamental gap in our understanding of PPCM is what the core pathobiology
driving this “2nd hit” is. Our group recently profiled the circulating proteome of women with PPCM or preeclampsia
(a major PPCM risk factor) to gain insights into their shared secretory pathophysiology. This paradoxically
identified the senescence-associated secretory phenotype (SASP), a marker of biological aging, as the most
highly upregulated biological process in these young women. Our preliminary data in human cohorts and
experimental models has identified strong associations between senescence biology and cardiac dysfunction
and HF severity in PPCM, and ultimately led us to a novel hypothesis that accelerated placental senescence is
the elusive root cause of the “2nd hit” in PPCM pathophysiology. The placenta, whose lifespan is limited to ~40
weeks, can be viewed as the fastest aging organ in the human body and notably becomes markedly senescent
by late pregnancy. Our objective here is to prove causality of placental senescence in PPCM. Here we propose
three integrated Specific Aims that incorporate rigorous gain- and loss-of-function experiments to definitively
answer this question. In Aim 1, we will use parabiosis and heterotopic placental implantation to determine if the
senescent placenta secretome is sufficient to induce cardiac dysfunction in PPCM-prone mice. In Aim 2, we will
incorporate pharmacological and genetic senolytic approaches to determine if placental senescence is
necessary in PPCM pathophysiology. Lastly, in Aim 3, we will systematically identify novel placenta-derived
senescence-associated secretory factors that induce pathologic cardiomyocyte hypertrophy, independent of
hemodynamic effects. This will integrate comprehensive functional, structural, and metabolic phenotyping with
proteomic and RNAseq profling in an ex vivo model system of human cardiomyocyte-placental crosstalk. Our
approach combines innovative hypotheses, state-of-the-art technology, and unique experimental strategies. The
proposed research is significant because it is expected to provide important new mechanistic insights into this
poorly understood HF syndrome that could fundamentally change the framework by which we approach cardiac
remodeling in pregnancy. The translational potential of this work is highlighted by our focus on secretory proteins
that can be targeted for therapeutic development, and could potentially be relevant to a broader spectrum of HF
syndromes associated with senescence (e.g....

## Key facts

- **NIH application ID:** 10875429
- **Project number:** 5R01HL170058-02
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** JASON DAVID ROH
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $457,978
- **Award type:** 5
- **Project period:** 2023-07-01 → 2028-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10875429

## Citation

> US National Institutes of Health, RePORTER application 10875429, Placental Senescence in Peripartum Cardiomyopathy (5R01HL170058-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10875429. Licensed CC0.

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