Thevissen Kristof, Demir Merve, Cornette Jerome, Gyselaers Wilfried
Department of Rheumatology, Ziekenhuis Oost-Limburg (ZOL), Genk, Belgium.
Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.
Front Med (Lausanne). 2022 Jul 5;9:904373. doi: 10.3389/fmed.2022.904373. eCollection 2022.
To evaluate microvasculature in pregnant women with and without cardiovascular risk factors.
Cross-sectional, observational study.
Women were recruited at the outpatient clinic for high risk prenatal care. Out of a total of 345 women assessed at first and/or second and/or third trimester, 169 women without and 176 with cardiovascular risk factors were included.
Nailfold video capillaroscopy (NVC) measurements were performed at magnification of 200x at all fingers except thumbs. Images were stored for offline measurement of capillary density (CDe) and capillary diameters (CDi). Maternal anthropometrics, obstetric, and medical history were used for categorization in low and high cardiovascular risk. Comparison between groups and trimesters, with respect to pregnancy outcome, was performed using linear mixed model analysis.
Women with a high risk cardiovascular profile show higher CDe, regardless of pregnancy outcome. CDi drops during pregnancy, with lowest CDi in third trimester in patients with preeclampsia. Capillary bed (CB), as a composite of CDe and CDi, is stable during pregnancy in women with low risk cardiovascular profile. In women with high risk cardiovascular profile, CB drops from the first to the second trimester, regardless of pregnancy outcome. Only in women with pre-eclampsia, the CB is lower in the third trimester as compared to the first trimester.There is an inverse association between CDe and mean arterial pressure (MAP) in women with high cardiovascular risk and pre-eclampsia.
Microcirculation is altered during the course of pregnancy and microcirculatory behavior is different in patients with low and high cardiovascular risk profile, as well as in patients with preeclampsia.
评估有无心血管危险因素的孕妇的微血管系统。
横断面观察性研究。
在高危产前门诊招募女性。在总共345名在孕早期和/或孕中期和/或孕晚期接受评估的女性中，纳入了169名无心血管危险因素的女性和176名有心血管危险因素的女性。
除拇指外，在所有手指上以200倍放大倍数进行甲襞视频毛细血管镜检查（NVC）测量。图像被存储用于离线测量毛细血管密度（CDe）和毛细血管直径（CDi）。使用孕妇的人体测量学、产科和病史对心血管风险进行低风险和高风险分类。使用线性混合模型分析对不同组和孕期之间的妊娠结局进行比较。
无论妊娠结局如何，心血管风险高的女性显示出更高的CDe。孕期CDi下降，子痫前期患者在孕晚期的CDi最低。毛细血管床（CB）作为CDe和CDi的综合指标，在心血管风险低的女性孕期中保持稳定。在心血管风险高的女性中，无论妊娠结局如何，CB从孕早期到孕中期下降。仅子痫前期女性的CB在孕晚期低于孕早期。心血管风险高和子痫前期女性的CDe与平均动脉压（MAP）呈负相关。
孕期微循环会发生改变，心血管风险低和高的患者以及子痫前期患者的微循环行为有所不同。
