既往早发型或晚发型子痫前期妊娠的女性升主动脉的弹性特性。

Elastic properties of ascending aorta in women with previous pregnancy complicated by early- or late-onset pre-eclampsia.

机构信息

Maternal Fetal Medicine Unit, Department of Obstetrics and Gynecology, University of Brescia, Brescia, Italy.

Section of Cardiovascular Diseases, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.

出版信息

Ultrasound Obstet Gynecol. 2016 Mar;47(3):316-23. doi: 10.1002/uog.14838. Epub 2016 Feb 11.

DOI:10.1002/uog.14838

PMID:25754870

Abstract

OBJECTIVES

To evaluate the elastic properties of the ascending aorta in women with a previous pregnancy complicated by early-onset (EO) or late-onset (LO) pre-eclampsia (PE) and the correlation with gestational age (GA), systolic/diastolic blood pressure (SBP/DBP) and mean uterine artery pulsatility index (UtA-PI) at diagnosis of the disease as well as with birth weight of the neonate.

METHODS

Thirty women who had a previous pregnancy complicated by EO-PE, 30 with a previous pregnancy complicated by LO-PE and 30 normal controls were selected retrospectively from our electronic database and then recalled for assessment from 6 months to 4 years after delivery. Data regarding GA, SBP/DBP and mean UtA-PI at the diagnosis of PE were obtained from medical records. At our assessment, aortic M-mode and tissue Doppler imaging (TDI) parameters were measured. Aortic diameters were assessed at end-diastole at four levels: Valsalva sinuses, sinotubular junction, tubular tract and aortic arch. Aortic compliance, distensibility, stiffness index (SI), Peterson's elastic modulus (EM), pulse-wave velocity and M-mode strain were calculated using standard formulae. Aortic expansion velocity, early and late diastolic retraction velocities and peak systolic tissue strain (TDI-ϵ) were determined.

RESULTS

Aortic diameters at the four levels were significantly greater in both EO-PE and LO-PE groups than in controls. Aortic compliance and distensibility and TDI-ϵ were lower in EO-PE than in LO-PE (P = 0.001, P = 0.002 and P = 0.011, respectively) and controls (P = 0.037, P = 0.044 and P = 0.013, respectively). SI and EM were higher in EO-PE than in LO-PE (P = 0.001 and P < 0.001, respectively) and than in controls (P = 0.035 and P = 0.036, respectively). Multivariate analysis showed GA, DBP and UtA-PI at diagnosis of PE to be independent predictors of aortic elastic properties.

CONCLUSIONS

摘要

目的

评估既往早发型（EO）或晚发型（LO）子痫前期（PE）妊娠女性升主动脉的弹性特性，并与疾病诊断时的妊娠周数（GA）、收缩压/舒张压（SBP/DBP）和平均子宫动脉搏动指数（UtA-PI）以及新生儿出生体重相关。

方法

我们从电子数据库中回顾性地选择了 30 名既往 EO-PE 妊娠女性、30 名既往 LO-PE 妊娠女性和 30 名正常对照者，并在产后 6 个月至 4 年内召回进行评估。从病历中获得 PE 诊断时的 GA、SBP/DBP 和平均 UtA-PI。在评估时，测量主动脉 M 型和组织多普勒成像（TDI）参数。在四个水平（Valsalva 窦、窦管连接部、管状部和主动脉弓部）测量舒张末期主动脉直径。使用标准公式计算主动脉顺应性、可扩张性、僵硬度指数（SI）、Peterson 弹性模量（EM）、脉搏波速度和 M 型应变。测量主动脉扩张速度、舒张早期和晚期回缩速度以及收缩期组织应变峰值（TDI-ϵ）。

结果

EO-PE 和 LO-PE 组的四个水平主动脉直径均显著大于对照组。EO-PE 的主动脉顺应性和可扩张性以及 TDI-ϵ均低于 LO-PE（P = 0.001、P = 0.002 和 P = 0.011）和对照组（P = 0.037、P = 0.044 和 P = 0.013）。EO-PE 的 SI 和 EM 高于 LO-PE（P = 0.001 和 P < 0.001）和对照组（P = 0.035 和 P = 0.036）。多变量分析显示，PE 诊断时的 GA、DBP 和 UtA-PI 是主动脉弹性特性的独立预测因素。