Low-flow mediated constriction as a marker of endothelial function in healthy pregnancy and preeclampsia: A pilot study

Dominique Mannaerts*, Ellen Faes, Jerome Cornette, Wilfried Gyselaers, Marc Spaanderman, Inge Goovaerts, Tibor Stoop, Ella Roelant, Yves Jacquemyn, Emeline M Van Craenenbroeck

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


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 languageEnglish
Pages (from-to)75-81
Number of pages7
JournalPregnancy Hypertension: an international journal of women's cardiovascular health
Publication statusPublished - Jul 2019


  • 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
  • Arterial stiffness
  • RISK
  • Preeclampsia

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