Left atrial strain and B-type natriuretic peptide: possible markers for diastolic dysfunction in preeclampsia patients

Iglesias, Daniel García; Velasco, Rut Álvarez; Escudero, Ana I; Colunga, Santiago; Fernandez, Paloma Lequerica; Bernardo, Ana Fernández; Escalera, María Vigil; Soroa, Miguel; Almendárez, Marcel; Prieto, Belén; Calvo, David; Rozado, José; Álvarez, Francisco V.; Hera, Jesús M. de la

doi:10.1093/eurjpc/zwab059

Cited by 3 publications

(4 citation statements)

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“…To gain insights into the identified proteins’ dynamics during hypertensive vs normotensive pregnancies, we performed a systematic review of studies reporting observational associations of the prioritized proteins with HDPs. Forty-three studies met our inclusion criteria (eFigure 3 in Supplement 1), encompassing 9749 pregnant individuals with protein measurements who enrolled from 1998 to 2020 in their respective studies. Of those, 3122 individuals (32.0%) experienced an HDP, including 939 (9.6%) with gestational hypertension, 2167 (22.2%) with preeclampsia, and 16 (0.2%) without information on HDP subtype.…”

Section: Resultsmentioning

confidence: 99%

“…Of those, 3122 individuals (32.0%) experienced an HDP, including 939 (9.6%) with gestational hypertension, 2167 (22.2%) with preeclampsia, and 16 (0.2%) without information on HDP subtype. The most frequently tested biomarker was NT-proBNP (n = 8940; 30 studies), followed by Gal-3 (n = 921; 11 studies), HSP27 (n = 363; 5 studies), and CD40 (n = 81; 2 studies). CSTB and ECP were both evaluated by a single study including 66 participants.…”

Section: Resultsmentioning

confidence: 99%

“…Observational data were consistent with mendelian randomization results for several proteins, with dynamic associations of these proteins with HDPs throughout gestation. recruited from population-based or health system-linked cohort studies, 22, [30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46] with HDP cases primarily identified using qualifying International Statistical Classification of Diseases and Related Health Problems, Ninth or Tenth Revision codes or phecodes; controls were primarily those with only normotensive pregnancies or all female individuals without codes for hypertension in pregnancy. 8,47 Biobanks and cohorts contributing data to the HDP GWAS meta-analyses began enrolling participants between 1989 and 2017; apart from a subset of cohorts contributing to the InterPregGen consortium, all other biobanks/cohorts began enrollment after 1999.…”

Section: Key Pointsmentioning

confidence: 99%

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Genetic Associations of Circulating Cardiovascular Proteins With Gestational Hypertension and Preeclampsia

Schuermans,

Truong,

Ardissino

et al. 2024

JAMA Cardiol

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ImportanceHypertensive disorders of pregnancy (HDPs), including gestational hypertension and preeclampsia, are important contributors to maternal morbidity and mortality worldwide. In addition, women with HDPs face an elevated long-term risk of cardiovascular disease.ObjectiveTo identify proteins in the circulation associated with HDPs.Design, Setting, and ParticipantsTwo-sample mendelian randomization (MR) tested the associations of genetic instruments for cardiovascular disease–related proteins with gestational hypertension and preeclampsia. In downstream analyses, a systematic review of observational data was conducted to evaluate the identified proteins’ dynamics across gestation in hypertensive vs normotensive pregnancies, and phenome-wide MR analyses were performed to identify potential non-HDP–related effects associated with the prioritized proteins. Genetic association data for cardiovascular disease–related proteins were obtained from the Systematic and Combined Analysis of Olink Proteins (SCALLOP) consortium. Genetic association data for the HDPs were obtained from recent European-ancestry genome-wide association study meta-analyses for gestational hypertension and preeclampsia. Study data were analyzed October 2022 to October 2023.ExposuresGenetic instruments for 90 candidate proteins implicated in cardiovascular diseases, constructed using cis-protein quantitative trait loci (cis-pQTLs).Main Outcomes and MeasuresGestational hypertension and preeclampsia.ResultsGenetic association data for cardiovascular disease–related proteins were obtained from 21 758 participants from the SCALLOP consortium. Genetic association data for the HDPs were obtained from 393 238 female individuals (8636 cases and 384 602 controls) for gestational hypertension and 606 903 female individuals (16 032 cases and 590 871 controls) for preeclampsia. Seventy-five of 90 proteins (83.3%) had at least 1 valid cis-pQTL. Of those, 10 proteins (13.3%) were significantly associated with HDPs. Four were robust to sensitivity analyses for gestational hypertension (cluster of differentiation 40, eosinophil cationic protein [ECP], galectin 3, N-terminal pro–brain natriuretic peptide [NT-proBNP]), and 2 were robust for preeclampsia (cystatin B, heat shock protein 27 [HSP27]). Consistent with the MR findings, observational data revealed that lower NT-proBNP (0.76- to 0.88-fold difference vs no HDPs) and higher HSP27 (2.40-fold difference vs no HDPs) levels during the first trimester of pregnancy were associated with increased risk of HDPs, as were higher levels of ECP (1.60-fold difference vs no HDPs). Phenome-wide MR analyses identified 37 unique non-HDP–related protein-disease associations, suggesting potential on-target effects associated with interventions lowering HDP risk through the identified proteins.Conclusions and RelevanceStudy findings suggest genetic associations of 4 cardiovascular disease–related proteins with gestational hypertension and 2 associated with preeclampsia. Future studies are required to test the efficacy of targeting the corresponding pathways to reduce HDP risk.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Key Pointsmentioning

confidence: 99%

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Genetic Associations of Circulating Cardiovascular Proteins With Gestational Hypertension and Preeclampsia

Schuermans,

Truong,

Ardissino

et al. 2024

JAMA Cardiol

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“…While other cardiac biomarkers, such us serum N-terminal pro-B type natriuretic peptide, have been correlated extensively with cardiac dysfunction that can develop in hypertensive pregnancies, there are very few data on the relationship between angiogenic markers and echocardiographic findings in pregnancy with HDP 8,9,23,24 . The use of angiogenic markers in women with suspected PE is of established clinical value in predicting the interval between diagnosis and delivery and maternal adverse outcome in HDP [25][26][27][28][29][30] .…”

Section: Interpretation Of Study Findings and Comparison With Publish...mentioning

confidence: 99%

Angiogenic markers and maternal echocardiographic indices in women with hypertensive disorders of pregnancy

Giorgione,

Di Fabrizio,

Giallongo

et al. 2024

Ultrasound in Obstet & Gyne

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ObjectiveThe maternal cardiovascular system of women with hypertensive disorders of pregnancy (HDP) can be impaired, with higher rates of left ventricular (LV) remodelling and diastolic dysfunction compared to normotensive pregnancies. The primary objective of this prospective study was to correlate cardiac indices obtained by transthoracic echocardiography (TTE) and circulating angiogenic markers, such as soluble fms‐like tyrosine kinase 1 (sFlt‐1) and placental growth factor (PlGF).Methods95 women with a pregnancy complicated by HDP and a group of 25 uncomplicated pregnancies at term underwent TTE and blood tests to measure sFlt‐1 and PLGF during the peripartum period (before delivery and within a week of giving birth). Spearman's rank correlation was used to report correlation coefficients between biomarkers and cardiac indices in the HDP population and controls.ResultsHDP group included 61 (64.2%) preeclamptic patients and, among them, 42 (68.9%) delivered before 37 weeks. 12 HDP out of 95 (12.6%) patients underwent blood samples and TTE after delivery, and, as they showed significantly lower levels of angiogenic markers, they were excluded from the analysis. There was a correlation between sFlt‐1 and LVMI (r=0.246, p=0.026) and E/e’ (r=0.272, p=0.014) in HDP (n=83), while in controls sFlt‐1 showed a correlation with RWT (r=0.409, p=0.043), lateral e’ (r=‐0.562, p=0.004) and E/e’ (r=0.417, p=0.042). PlGF correlated with LVMI (r=‐0.238, p=0.031) in HDP patients and with lateral e’ (r=0.466, p=0.022) in controls. sFlt‐1/PlGF ratio correlated with lateral e’ (r=‐0.568, p=0.004) and E/e’ (r=0.428, p=0.037) in controls and with LVMI (r=0.252, p=0.022) and E/e’ (r=0.269, p=0.014) in HDP.ConclusionsAlthough the current data are not able to infer causality, they confirm the intimate relationship between the maternal cardiovascular system and endothelial markers that are used both to diagnose and indicate the severity of HDP.This article is protected by copyright. All rights reserved.

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Echocardiographic assessment of left atrial mechanics in women with hypertensive disorders of pregnancy: A systematic review and meta-analysis

Sonaglioni,

Pusca,

Casieri

et al. 2024

European Journal of Obstetrics & Gynecology and Reproductiv

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Left atrial strain and B-type natriuretic peptide: possible markers for diastolic dysfunction in preeclampsia patients

Cited by 3 publications

References 10 publications

Genetic Associations of Circulating Cardiovascular Proteins With Gestational Hypertension and Preeclampsia

Genetic Associations of Circulating Cardiovascular Proteins With Gestational Hypertension and Preeclampsia

Angiogenic markers and maternal echocardiographic indices in women with hypertensive disorders of pregnancy

Echocardiographic assessment of left atrial mechanics in women with hypertensive disorders of pregnancy: A systematic review and meta-analysis

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