Dopplerfluxometria de artérias oftálmicas e avaliação da função endotelial nas formas precoce e tardia da pré-eclâmpsia

Abstract

Objective: To identify possible differences between endothelial dysfunction evaluated by brachial artery flow-mediated dilation and central hyperperfusion evaluated by dopplerfluxometry of ophthalmic artery in women with early-and lateonset preeclampsia. Materials and Methods: Flow-mediated dilation testing and dopplerfluxometry of ophthalmic artery were performed in 81 patients (26 with early preeclampsia, 30 with late preeclampsia, and 25 normotensive pregnant women -control group). Results: As compared with the control group, patients with preeclampsia presented lower values of flow-mediated dilation, both in cases of early preeclampsia (7.62 ± 5.42% × 14.12 ± 6.14%; p = 0.02) and in cases of late preeclampsia (5.83 ± 4.12% × 14.12 ± 6.14%; p = 0.00). No statistically significant difference was observed between early-and late-onset preeclampsia (7.62 ± 5.42% × 5.83 ± 4.12%; p = 0.09). Values for dopplerfluxometry of ophthalmic artery were significant lower in patients with preeclampsia as compared with the control group, both in cases of early preeclampsia (0.631 ± 0.024 × 0.737 ± 0.032; p = 0.01) and in cases of late preeclampsia (0.653 ± 0.019 × 0.737 ± 0.032; p = 0.03). Again, no statistically significant difference was observed between early-and late-onset preeclampsia (0.631 ± 0.024 × 0.653 ± 0.019; p = 0.12). Basically, the results demonstrate a decrease in values for dopplerfluxometry of ophthalmic artery in patients with early and late presentations of preeclampsia as compared with the control group, although with no statistically significant difference between the two presentations of the disease. Conclusion: The present results indicate the presence of endothelial dysfunction and central hyperperfusion in patients with early-and late-onset preeclampsia. Keywords: Preeclampsia; Flow-mediated dilation; Ophthalmic arteries.Objetivo: Avaliar possíveis diferenças entre a disfunção endotelial, avaliada pela dilatação fluxo-mediada, e hiperperfusão central, avaliada por dopplerfluxometria da artéria oftálmica, entre pacientes portadoras da forma precoce e tardia da pré-eclâmpsia. Materiais e Métodos: O teste de dilatação fluxo-mediada e a dopplerfluxometria da artéria oftálmica foram obtidos de 81 gestantes, sendo 56 portadoras de pré-eclâmpsia (26 na forma precoce e 30 na forma tardia) e 25 gestantes saudáveis (grupo controle). Resultados: Portadoras de pré-eclâmpsia apresentaram valores menores de dilatação fluxo-mediada quando comparadas ao grupo controle, tanto na forma precoce (7,62 ± 5,42% × 14,12 ± 6,14%; p = 0,02) como na forma tardia (5,83 ± 4,12% × 14,12 ± 6,14%; p = 0,00). Não houve diferença quando foram comparadas as duas formas (7,62 ± 5,42% × 5,83 ± 4,12%; p = 0,09). A dopplerfluxometria da artéria oftálmica apresentou-se significativamente menor nas pacientes portadoras de pré-eclâmpsia quando comparadas ao grupo controle, tanto na forma precoce (0,631 ± 0,024 × 0,737 ± 0,032; p = 0,01) como na forma tardia (0,653 ± 0,019 × 0,737 ± 0,032; p = 0,03). Não houve diferença entre as duas formas ...

First‐trimester maternal ophthalmic artery Doppler analysis for prediction of pre‐eclampsia

“…Brandão et al . found the RI to be lower among 26 patients with early‐onset PE and in 30 patients with late‐onset PE compared with 28 healthy controls in a cross‐sectional study during the third trimester.…”

Função endotelial, perfusão uterina e fluxo central em gestações complicadas por Pré-Eclampsia

“…Possible explanations for this fact are based on the principle that the central hyperflow may occur after the blood pressure increase and glomerular endothelial injury, so that the clinical manifestations of PE precede the decrease in OARI in affected patients. A study carried out in our center has demonstrated a significant decrease in OARI at the moment when the PE was diagnosed 24 , in both its early and late forms. New studies that evaluate the behavior of OARI at the later gestational ages, such as the beginning of the third trimester, could validate the In conclusion, our results demonstrate that impaired placental perfusion and systemic endothelial dysfunction temporarily precede the clinical manifestations of PE, which does not occur with central hyperflow.…”

Prediction of preeclampsia by means of Doppler flowmetry of uterine artery and flow-mediated dilation of brachial artery

“…Endothelial injury evaluated by FMD is well established in patients with diagnosis of PE, either in cases of early or late presentation (15) . In a study developed by Savvidou et al, the methods association was more effective in the identification of the patients at risk for developing PE and restricted intrauterine growth than Doppler flowmetry of uterine arteries alone (16) .…”