Flow-mediated dilation and peripheral arterial tonometry are disturbed in preeclampsia and reflect different aspects of endothelial function

Abstract

Endothelial function and arterial stiffness are known to be altered in preeclamptic pregnancies. Previous studies have shown conflicting results regarding the best technique for assessing vascular function in pregnancy. In this study, we made a comprehensive evaluation of in vivo vascular function [including flow-mediated dilatation (FMD), peripheral arterial tonometry (PAT), and arterial stiffness] in preeclamptic patients and compared them with normal pregnancies. In addition, we assessed the relation between vascular function and systemic inflammation. Fourteen patients with preeclampsia (PE) and 14 healthy pregnant controls were included. Endothelial function was determined by FMD and PAT and arterial stiffness by carotid-femoral pulse-wave velocity and augmentation index. Systemic inflammation was assessed using mean platelet volume (MPV) and neutrophil-lymphocyte ratio (NLR). The reactive hyperemia index, assessed using PAT, is decreased at the third trimester compared with the first trimester in a normal, uncomplicated pregnancy ( = 0.001). Arterial stiffness is significantly higher in PE versus normal pregnancy ( < 0.001). Endothelial function, obtained by FMD, is deteriorated in PE versus normal pregnancy ( = 0.015), whereas endothelial function assessment by PAT is improved in PE versus normal pregnancy ( = 0.001). Systemic inflammation (MPV and NLR) increases during normal pregnancy. FMD and PAT are disturbed in PE. Endothelial function, assessed by FMD and PAT, shows distinct results. This may indicate that measurements with FMD and PAT reflect different aspects of endothelial function and that PAT should not be used as a substitute for FMD as a measure of endothelial function in pregnancy.

Evaluation of Vascular Endothelial Function in Young and Middle-Aged Women with Respect to a History of Pregnancy, Pregnancy-Related Complications, Classical Cardiovascular Risk Factors, and Epigenetics

“…The majority of studies on the assessment of vascular endothelial function using peripheral arterial tonometry and EndoPAT 2000 device was performed in women during gestation with the aim to describe potential association between vascular endothelial dysfunction and pregnancy-induced hypertension or preeclampsia [20,23,[50][51][52][53], sleep-disordered breathing in women with preeclamptic toxaemia [54], and smoking status [55].…”

Oxidative stress in healthy pregnancy and preeclampsia is linked to chronic inflammation, iron status and vascular function

“…Vascular measurements were performed as previously described. [ 9 ] To keep the focus on OS, detailed results of vascular measurements are described separately.…”

“…[ 16 ] The profound hemodynamic changes of pregnancy can be objectified by assessing endothelial function and vascular stiffness with peripheral arterial tonometry (PAT) and applanation tonometry and they are proven to be disturbed in PE pregnancies. [ 9 ] Determination of ROS in blood during pregnancy and PE is of wide interest to specialists in perinatal medicine, but the best technique to access OS has been matter of debate. [ 5 , 17 ]Therefore, we performed a study by applying electron paramagnetic/spin resonance (EPR/ESR) spectroscopy as a direct method to detect ROS by using the spin-probe CMH (hydroxy-3-methoxycarbonyl-2,2,5,5-tetramethylpyrrolidine) to detect superoxide concentrations in blood.…”

Oxidative stress and endothelial function in normal pregnancy versus pre-eclampsia, a combined longitudinal and case control study

“…Due to measurement of peripheral microcirculatory function, PAT is less NO-dependent than FMD. As such, FMD and PAT assess different aspects of vascular function [ 43 – 45 ]. Arterial stiffness has been evaluated in pregnancy, using applanation tonometry (AP) [ 2 ].…”