Paauw Nina D, Joles Jaap A, Spradley Frank T, Bakrania Bhavisha, Zsengeller Zsuzsanna K, Franx Arie, Verhaar Marianne C, Granger Joey P, Lely A Titia
Department of Obstetrics, Wilhelmina Children's Hospital Birth Center, University Medical Center Utrecht, Utrecht, The Netherlands;
Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands.
Am J Physiol Regul Integr Comp Physiol. 2017 May 1;312(5):R664-R670. doi: 10.1152/ajpregu.00510.2016. Epub 2017 Feb 15.
Women with a history of preeclampsia (PE) have an increased risk to develop cardiovascular and renal diseases later in life, but the mechanisms underlying this effect are unknown. In rats, we assessed whether placental ischemia results in long-term effects on the maternal cardiovascular and renal systems using the reduced uterine perfusion pressure (RUPP) model for PE. Sprague-Dawley rats received either a Sham or RUPP operation at gestational The rats were followed for 8 wk after delivery (Sham = 12, RUPP = 21) at which time mean arterial pressure (MAP; conscious), 24-h albuminuria, glomerular filtration rate (GFR; transcutaneous, FITC-sinistrin), and cardiac function (Vevo 770 system) were assessed. Subsequently, all rats were euthanized for mesenteric artery vasorelaxation and histology of heart and kidney. At 8 wk after delivery, there was no difference in MAP and albuminuria. However, RUPP rats showed a significantly reduced GFR [2.61 ± 0.53 vs. 3.37 ± 0.74 ml/min; = 0.01]. Ultrasound showed comparable cardiac structure, but RUPP rats had a lower left ventricular ejection fraction (62 ± 7 vs. 69 ± 10%; = 0.04). Heart and kidney histology was not different between Sham or RUPP rats. Furthermore, there were no differences in endothelial-dependent or -independent vasorelaxation. We show that exposure to placental ischemia in rats is accompanied by functional disturbances in maternal renal and cardiac function 8 wk after a preeclamptic pregnancy. However, these changes were not dependent on differences in blood pressure, small artery vasorelaxation, or cardiac and renal structure at this time point postpartum.
有子痫前期(PE)病史的女性在晚年患心血管和肾脏疾病的风险增加,但其潜在机制尚不清楚。在大鼠中,我们使用PE的降低子宫灌注压(RUPP)模型评估胎盘缺血是否会对母体心血管和肾脏系统产生长期影响。在妊娠时,将Sprague-Dawley大鼠分为假手术组或RUPP手术组。产后对大鼠进行8周的随访(假手术组 = 12只,RUPP组 = 21只),在此期间评估平均动脉压(MAP;清醒状态下)、24小时蛋白尿、肾小球滤过率(GFR;经皮,异硫氰酸荧光素标记的司他斯汀)和心脏功能(Vevo 770系统)。随后,对所有大鼠实施安乐死,用于评估肠系膜动脉血管舒张功能以及心脏和肾脏的组织学情况。产后8周时,MAP和蛋白尿无差异。然而,RUPP组大鼠的GFR显著降低[2.61±0.53 vs. 3.37±0.74 ml/min;P = 0.01]。超声检查显示心脏结构相似,但RUPP组大鼠的左心室射血分数较低(62±7 vs. 69±10%;P = 0.04)。假手术组和RUPP组大鼠的心脏和肾脏组织学无差异。此外,内皮依赖性或非依赖性血管舒张功能也无差异。我们发现,大鼠经历胎盘缺血后,在子痫前期妊娠8周后母体肾脏和心脏功能出现功能障碍。然而,这些变化在产后这个时间点并不依赖于血压、小动脉血管舒张功能或心脏和肾脏结构的差异。