Orabona R, Sciatti E, Vizzardi E, Bonadei I, Valcamonico A, Metra M, Frusca T
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.
Ultrasound Obstet Gynecol. 2017 Jan;49(1):116-123. doi: 10.1002/uog.15893.
Pre-eclampsia (PE) is associated with an increased cardiovascular risk later in life. The persistence of endothelial dysfunction after delivery may represent the link between PE and cardiovascular disease. We aimed to evaluate endothelial function and arterial stiffness after delivery of pregnancy complicated by early-onset (EO) or late-onset (LO) PE and their correlation with gestational age and mean uterine artery pulsatility index at PE diagnosis and birth-weight percentile.
The study included 30 women with previous EO-PE, 30 with previous LO-PE and 30 controls with no previous PE. Participants were examined at between 6 months and 4 years after delivery. All included women were free from cardiovascular risk factors and drugs. Data on demographic and clinical characteristics during pregnancy were collected retrospectively from obstetrical charts. Endothelial function and arterial stiffness were assessed by peripheral arterial tonometry and pulse-wave analysis.
All vascular parameters were significantly different, indicating circulatory impairment, in women with previous EO-PE. Women with previous LO-PE had higher vascular rigidity than did controls and all had normal values of reactive hyperemia index, although they were significantly lower when compared with those of controls. On multivariate analysis, gestational age and mean uterine artery pulsatility index at the time of PE diagnosis, and birth-weight percentile were all statistically related to the vascular indices studied, after correcting for confounding parameters.
Women with previous pregnancy complicated by PE, in particular those with early-onset disease, showed persistent microcirculatory dysfunction, as suggested by a significant reduction in reactive hyperemia index value, and increased arterial stiffness. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
子痫前期（PE）与日后心血管疾病风险增加相关。产后内皮功能障碍的持续存在可能是PE与心血管疾病之间的联系。我们旨在评估早发型（EO）或晚发型（LO）PE合并妊娠产后的内皮功能和动脉僵硬度，以及它们与孕周、PE诊断时的平均子宫动脉搏动指数和出生体重百分位数的相关性。
该研究纳入30例既往有EO-PE的女性、30例既往有LO-PE的女性和30例无既往PE的对照者。在产后6个月至4年对参与者进行检查。所有纳入的女性均无心血管危险因素且未服用药物。妊娠期间的人口统计学和临床特征数据从产科病历中回顾性收集。通过外周动脉张力测定和脉搏波分析评估内皮功能和动脉僵硬度。
既往有EO-PE的女性所有血管参数均有显著差异，表明存在循环障碍。既往有LO-PE的女性血管僵硬度高于对照组，且所有患者反应性充血指数值均正常，尽管与对照组相比显著降低。多因素分析显示，在校正混杂参数后，PE诊断时的孕周、平均子宫动脉搏动指数和出生体重百分位数均与所研究的血管指数有统计学关联。
既往妊娠合并PE的女性，尤其是早发型疾病患者，表现出持续的微循环功能障碍，反应性充血指数值显著降低和动脉僵硬度增加提示了这一点。版权所有©2016国际妇产科超声学会。由约翰·威利父子有限公司出版。
