Blaauw Judith, Souwer Esteban T D, Coffeng Sophie M, Smit Andries J, van Doormaal Jasper J, Faas Marijke M, van Pampus Maria G
Department of Obstetrics and Gynecology, University of Groningen and University Medical Center Groningen, Groningen, the Netherlands.
Acta Obstet Gynecol Scand. 2014 Dec;93(12):1309-16. doi: 10.1111/aogs.12499. Epub 2014 Sep 30.
Early-onset preeclampsia is associated with premature cardiovascular disease. We previously demonstrated that femoral intima-media thickness (IMT) and markers of cardiovascular disease were increased in women 1 year after early-onset preeclampsia. The current study measured (progression of) IMT, cardiovascular disease risk factors and markers of endothelial cell dysfunction 4-5 years postpartum in the same women.
Case-control study.
Formerly preeclamptic women.
IMT of carotid and femoral arteries was measured by ultrasound, as a marker of subclinical atherosclerosis. Various conventional cardiovascular risk factors were determined, as well as serum markers of endothelial cell activation and inflammation. Values were compared with those 1 year after the first (preeclamptic) pregnancy.
We included 17 formerly preeclamptic women (cases) and 16 controls. Mean interval between index delivery and day of investigation was 4.7 years for the cases and 4.3 years for the controls. Neither differences nor progression of IMT was observed between the cases and the controls. Increased blood pressure, body mass index, serum triglycerides and inflammatory markers were found in the cases compared with the controls.
IMT was not increased in women with an almost 5-year history of severe preeclampsia as an indicator of increased cardiovascular risk. This study suggests a transient adaptive response of the arteries in formerly preeclamptic women. The persistence of cardiovascular risk factors in this group emphasizes the need for long-term follow-up.
早发型子痫前期与心血管疾病过早发生有关。我们之前证明，早发型子痫前期发生后1年，女性的股动脉内膜中层厚度（IMT）及心血管疾病标志物增加。本研究测量了同一批女性产后4 - 5年时IMT（的进展情况）、心血管疾病危险因素及内皮细胞功能障碍标志物。
病例对照研究。
曾患子痫前期的女性。
通过超声测量颈动脉和股动脉的IMT，作为亚临床动脉粥样硬化的标志物。测定各种传统心血管危险因素以及内皮细胞活化和炎症的血清标志物。将这些值与首次（子痫前期）妊娠后1年时的值进行比较。
IMT结果：我们纳入了17名曾患子痫前期的女性（病例组）和16名对照组。病例组从指数分娩到调查日的平均间隔时间为4.7年，对照组为4.3年。病例组和对照组之间未观察到IMT差异或进展情况。与对照组相比，病例组的血压、体重指数、血清甘油三酯和炎症标志物升高。
作为心血管风险增加的指标，有近5年重度子痫前期病史的女性IMT未增加。本研究提示曾患子痫前期的女性动脉存在短暂的适应性反应。该组心血管危险因素的持续存在强调了长期随访的必要性。
