Ziganshina Marina M, Muminova Kamilla T, Khasbiullina Nailia R, Khodzhaeva Zulfiya S, Yarotskaya Ekaterina L, Sukhikh Gennady T
National Medical Research Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health of the Russian Federation, Oparina Street 4, Moscow 117997, Russia.
Department of Obstetrics, Gynecology, Perinatology and Reproductology, Institute of Professional Education, I.M. Sechenov First Moscow State Medical University, Trubetskaya Street 8-2, Moscow 119991, Russia.
Biomedicines. 2022 Nov 2;10(11):2790. doi: 10.3390/biomedicines10112790.
This paper provides an assessment of molecular and functional changes in blood vessels, and a description of vascular patterns during preeclampsia (PE). Patients with normal pregnancy, and pregnancy complicated by PE at earlier (20-34 weeks) and later terms (≥34 weeks) underwent a 24 h monitoring of blood pressure, central hemodynamics, arterial stiffness, and myocardial function. The blood levels of the structural components of endothelial glycocalyx (eGC): syndecan-1 (SDC 1), heparan sulfate proteoglycan 2 (HSPG2), and hyaluronic acid (HA) were determined. In early-onset PE, the vascular pattern comprised changes in all structural components of eGCs, including transmembrane proteoglycans levels, and severe disorders of central hemodynamics, arterial stiffness, and myocardial changes, probably leading to more severe course of PE and the formation of morphological grounds for cardiovascular disorders. The vascular pattern in late-onset PE, including changes in HA levels, central hemodynamics, and myocardial function, may be a signal of potential cardiovascular disorder. PE may change adaptive hemodynamic responses to a pathological reaction affecting both arterial elasticity and the left ventricular myocardium, with its subsequent hypertrophy and decompensation, leading to a delayed development of cardiovascular disorders after PE. Further clinical studies of these indicators will possibly identify predictors of PE and long-term consequences of the disease.
本文评估了子痫前期（PE）期间血管的分子和功能变化，并描述了血管模式。对正常妊娠以及在早期（20 - 34周）和晚期（≥34周）合并PE的孕妇进行了24小时血压、中心血流动力学、动脉僵硬度和心肌功能监测。测定了内皮糖萼（eGC）结构成分的血液水平： syndecan - 1（SDC 1）、硫酸乙酰肝素蛋白聚糖2（HSPG2）和透明质酸（HA）。在早发型PE中，血管模式包括eGC所有结构成分的变化，包括跨膜蛋白聚糖水平，以及中心血流动力学、动脉僵硬度和心肌变化的严重紊乱，这可能导致PE病情更严重，并为心血管疾病形成形态学基础。晚发型PE的血管模式，包括HA水平、中心血流动力学和心肌功能的变化，可能是潜在心血管疾病的信号。PE可能会改变对影响动脉弹性和左心室心肌的病理反应的适应性血流动力学反应，随后导致心肌肥厚和失代偿，从而导致PE后心血管疾病的延迟发生。对这些指标的进一步临床研究可能会确定PE的预测因素以及该疾病的长期后果。
