Robb Amy O, Mills Nicholas L, Din Jehangir N, Smith Imogen B J, Paterson Finny, Newby David E, Denison Fiona C
Centres for Reproductive Biology, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom.
Hypertension. 2009 Jun;53(6):952-8. doi: 10.1161/HYPERTENSIONAHA.109.130898. Epub 2009 Apr 27.
Arterial stiffness and compliance are major predictors of adverse cardiovascular events and are influenced by female sex hormones, including estrogen and progesterone. The aim of this longitudinal study was to evaluate the effect of the menstrual cycle, normal pregnancy, and preeclampsia on central and systemic arterial stiffness. Ten healthy nulliparous women with regular menses were studied in the early and midfollicular, periovulatory, and luteal phases of a single menstrual cycle. Twenty-two primigravida pregnant women were studied throughout pregnancy at 16, 24, 32, and 37 weeks gestation and at 7 weeks postpartum. Fifteen primigravida women with preeclampsia were studied at diagnosis and 7 weeks postpartum. Augmentation index and carotid-radial and carotid-femoral pulse wave velocities were measured using applanation tonometry. Augmentation index fell during the luteal phase of the menstrual cycle (luteal phase versus periovulatory phase; P<0.05). In normal pregnancy, pulse wave velocity and augmentation index increased from 24 weeks over the third trimester (P<or=0.01 for both). All of the measures were increased in women with preeclampsia (P<or=0.01), with augmentation index and carotid-femoral pulse wave velocity remaining elevated 7 weeks postpartum (P<or=0.02). We conclude that systemic arterial stiffness undergoes major changes during the menstrual cycle and pregnancy and that preeclampsia is associated with greater and more prolonged increases in arterial stiffness. These effects may contribute to adverse cardiovascular outcomes of pregnancy and preeclampsia.
动脉僵硬度和顺应性是心血管不良事件的主要预测指标，并受包括雌激素和孕激素在内的女性性激素影响。这项纵向研究的目的是评估月经周期、正常妊娠和先兆子痫对中心和全身动脉僵硬度的影响。对10名月经周期规律的未孕健康女性在单个月经周期的卵泡早期、卵泡中期、排卵期和黄体期进行了研究。对22名初孕妇在妊娠16、24、32和37周以及产后7周整个孕期进行了研究。对15名先兆子痫初孕妇在诊断时和产后7周进行了研究。使用压平式眼压计测量增强指数以及颈-桡和颈-股脉搏波速度。月经周期的黄体期增强指数下降（黄体期与排卵期相比；P<0.05）。在正常妊娠中，脉搏波速度和增强指数在孕晚期从24周开始增加（两者均P≤0.01）。先兆子痫女性的所有测量值均升高（P≤0.01），增强指数和颈-股脉搏波速度在产后7周仍升高（P≤0.02）。我们得出结论，全身动脉僵硬度在月经周期和妊娠期间会发生重大变化，并且先兆子痫与动脉僵硬度更大且持续时间更长的增加有关。这些影响可能导致妊娠和先兆子痫的不良心血管结局。
