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Title
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Low-flow mediated constriction as a marker of endothelial function in healthy pregnancy and preeclampsia: A pilot study
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Author
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Abstract
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| 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. |
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Language
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English
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Source (journal)
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Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health
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HEALTH
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Publication
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2019
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ISSN
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2210-7789
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DOI
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10.1016/J.PREGHY.2019.02.001
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Volume/pages
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17
(2019)
, p. 75-81
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ISI
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000484410100014
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Pubmed ID
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31487661
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Full text (Publisher's DOI)
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Full text (open access)
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Full text (publisher's version - intranet only)
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