Abstract
OBJECTIVES: Overwhelming clinical evidence exists on disturbed vascular and endothelial function in the pathophysiology of preeclampsia (PE). In a non-pregnant (NP) population, L-FMC (low-flow mediated constriction) provides insight in the 'resting' endothelial capacity in contrast to the gold standard of flow mediated dilatation (FMD), reflecting endothelial nitric oxide bioavailability.
STUDY DESIGN: Longitudinal follow-up of 100 healthy pregnant (HP) women, 33 PE women and 16 NP controls with non-invasive vascular assessments. HP women were evaluated at 12 and 35 weeks of gestation and at 6 months postpartum. PE patients were assessed at diagnosis (mean 30 weeks) and 6 months postpartum.
MAIN OUTCOME MEASURES: Endothelial function (L-FMC, FMD, peripheral arterial tonometry (PAT)) and arterial stiffness (pulse wave velocity (PWV) and analysis (PWA)) were measured at the different visits and compared between groups.
RESULTS: Overall endothelial dysfunction is present in PE (FMD HP 9.09 ± 4.20 vs PE 5.21 ± 4.47, p = 0.0004; L-FMC HP -1.90 ± 2.66 vs PE -0.40 ± 2.09, p = 0.03). L-FMC gradually elevates during the course of a HP (1st trim -0.31 ± 1.75 vs 3rd trim -1.97 ± 3.02, p < 0.0001) and is present in 85% of women in the third trimester. In NP, only 27% of women has L-FMC. In PE, L-FMC is present in 50% of cases. Arterial stiffness is increased in PE (all p < 0.0001). There is no correlation between L-FMC and other markers of vascular function (p > 0.05).
CONCLUSION: PE is characterized by dysfunction of both resting and recruitable endothelial capacity. This study offers new insights in different aspects of endothelial function in pregnancy, since L-FMC reflects an adaptation in HP that is absent in PE.
Original language | English |
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Pages (from-to) | 75-81 |
Number of pages | 7 |
Journal | Pregnancy Hypertension |
Volume | 17 |
DOIs | |
Publication status | Published - Jul 2019 |
Keywords
- Adult
- Biomarkers
- Endothelium, Vascular/physiopathology
- Female
- Humans
- Manometry
- Pilot Projects
- Pre-Eclampsia/diagnosis
- Predictive Value of Tests
- Pregnancy
- Pregnancy Trimester, Third
- Prenatal Diagnosis
- Regional Blood Flow
- Vascular Stiffness
- Flow mediated dilatation
- Low-flow mediated constriction
- Endothelial function
- BRACHIAL-ARTERY
- DYSFUNCTION
- MANAGEMENT
- Arterial stiffness
- RISK
- DILATION
- AORTIC STIFFNESS
- PREDICTION
- WOMEN
- IMPACT
- Preeclampsia
- ARTERIAL STIFFNESS