Maternal Wave Reflections and Arterial Stiffness in Normal Pregnancy as Assessed by Applanation Tonometry

Macedo, Maria L.; Luminoso, Daniele; Savvidou, Makrina D.; McEniery, Carmel M.; Nicolaides, Kypros H.

doi:10.1161/hypertensionaha.107.106062

Cited by 110 publications

(79 citation statements)

References 37 publications

(40 reference statements)

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“…There are many studies showing similar results using central artery compliance by invasive procedures (mean arterial pressure, aortic augmentation index (AIx) and central systolic blood pressure (SBP) [7,13] and non invasive techniques (MRI and USG) [14,15]. But contrary to our study some of the studies have not shown change in peripheral arterial compliance during different phases of menstrual cycle [7,16]. …”

Section: Resultscontrasting

confidence: 77%

Effect of Different Phases of Menstrual Cycle on Reflection Index, Stiffness index and Pulse wave velocity in Healthy subjects

S¹

2014

JCDR

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Introduction: Arterial compliance will result in stabilizing the fluctuations in arterial pressure and blood flow. So arterial stiffness can be a good indicator for monitoring the cardiovascular system. Arterial stiffness can be measured using indices like reflection index (RI), stiffness index (SI) and Brachial Finger Pulse Wave Velocity (BFPWV).Objectives: Aim of our study was to evaluate the changes in RI, SI and BFPWV during different phases of the menstrual cycle and to correlate RI with SI in healthy female subjects between the age group of 18-30 years from Bangalore, India. Materials and Methods:Basal recordings of RI and SI were determined by Photo Pulse Plethysmography (PPG) picked up from the fingertip using BIOPAC system and BFPWV was obtained using Doppler. Recordings were obtained at three different time points during the menstrual cycle. Analysis was done using repeated measures ANOVA with Bonferroni correction.Result: There was a significant decrease in above parameters p<0.05 during the mid-cycle. Correlation between RI and SI was also significant p<0.05. Conclusion:These findings suggests that the menstrual cycle affects the arterial stiffness and one of the factor is oestrogen. Hence, women are less prone to the incidence of cardiovascular diseases before menopause. Screening for arterial stiffness in a general population, using these indices is valid, economical and reliable.

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Section: Resultscontrasting

confidence: 77%

Effect of Different Phases of Menstrual Cycle on Reflection Index, Stiffness index and Pulse wave velocity in Healthy subjects

S¹

2014

JCDR

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“…Our findings support two recent studies, which addressed normal values of cSBP and AIx throughout pregnancy. 19,20 Furthermore, we found that AIx-75, but not cSBP, was independent of bSBP throughout pregnancy. Our present data suggested that measurement of cSBP and AIx might offer additional information about maternal arterial compliance, which might be impaired in various obstetric complications such as preeclampsia.…”

Section: Discussionmentioning

confidence: 55%

“…17 In addition, women with a history of earlyonset preeclampsia and intrauterine growth restriction were reported to exhibit increased AIx even 6 to 24 months postpartum. 18 Although two recent studies addressed normal values of cSBP and AIx throughout pregnancy showing its nadir in mid-pregnancy, 19,20 their physiological aspects in healthy pregnant individuals, such as their relationships to brachial blood pressure, are currently unknown.…”

Section: Introductionmentioning

confidence: 99%

Central aortic blood pressure and augmentation index during normal pregnancy

et al. 2012

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The current study tested the hypothesis that pregnancy-related changes are more pronounced in central hemodynamics, and both central aortic systolic blood pressure (cSBP) and augmentation index (AIx) are independent from brachial systolic blood pressure (bSBP) in normal pregnant subjects. In 830 healthy pregnant women from 12 to 36 weeks gestation, we measured cSBP and AIx-75 (AIx at heart rate of 75 beats per minute) non-invasively by pulse waveforms of the radial artery using an automated applanation tonometric system. In 69 pregnant women, we recorded these data longitudinally. cSBP and AIx-75 significantly declined during pregnancy, reaching its nadir in mid-pregnancy and rising towards term. Pregnancy-related changes were more pronounced in AIx-75 compared with cSBP, but less evident in bSBP. AIx-75, but not cSBP, was independent from bSBP throughout pregnancy. cSBP and AIx-75, but not bSBP, were significantly increased in healthy pregnant women older than 35 years. This study established normal values for pulse wave analysis parameters throughout pregnancy, and indicated that pulse wave analysis might offer additional and independent information about maternal arterial compliance to conventional brachial blood pressure measurements. These data may be used as the basis for further investigation into the role of pulse wave analysis in the assessment, management and prediction of disorders, which might interfere with pregnancy-related cardiovascular adaptations.

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“…27 Our findings of a rise in arterial stiffness from the second trimester to term and postnatally are supportive of previous studies using brachial-ankle PWV as a composite measure of systemic and central stiffness 28 and augmentation index. 29 Other studies report no change in PWV with gestation 30 or a general decrease in PWV and augmentation index during pregnancy. 6,8,9,11 All of these studies had limited and wide time points, with the third-trimester visits performed earlier than in our study.…”

Section: Discussionmentioning

confidence: 99%

Influence of the Menstrual Cycle, Pregnancy, and Preeclampsia on Arterial Stiffness

et al. 2009

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Abstract-Arterial stiffness and compliance are major predictors of adverse cardiovascular events and are influenced by female sex hormones, including estrogen and progesterone. The aim of this longitudinal study was to evaluate the effect of the menstrual cycle, normal pregnancy, and preeclampsia on central and systemic arterial stiffness. Ten healthy nulliparous women with regular menses were studied in the early and midfollicular, periovulatory, and luteal phases of a single menstrual cycle. Twenty-two primigravida pregnant women were studied throughout pregnancy at 16, 24, 32, and 37 weeks gestation and at 7 weeks postpartum. Fifteen primigravida women with preeclampsia were studied at diagnosis and 7 weeks postpartum. Augmentation index and carotid-radial and carotid-femoral pulse wave velocities were measured using applanation tonometry. Augmentation index fell during the luteal phase of the menstrual cycle (luteal phase versus periovulatory phase; PϽ0.05). In normal pregnancy, pulse wave velocity and augmentation index increased from 24 weeks over the third trimester (PՅ0.01 for both). All of the measures were increased in women with preeclampsia (PՅ0.01), with augmentation index and carotid-femoral pulse wave velocity remaining elevated 7 weeks postpartum (PՅ0.02). We conclude that systemic arterial stiffness undergoes major changes during the menstrual cycle and pregnancy and that preeclampsia is associated with greater and more prolonged increases in arterial stiffness. These effects may contribute to adverse cardiovascular outcomes of pregnancy and preeclampsia.

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Maternal Wave Reflections and Arterial Stiffness in Normal Pregnancy as Assessed by Applanation Tonometry

Cited by 110 publications

References 37 publications

Effect of Different Phases of Menstrual Cycle on Reflection Index, Stiffness index and Pulse wave velocity in Healthy subjects

Effect of Different Phases of Menstrual Cycle on Reflection Index, Stiffness index and Pulse wave velocity in Healthy subjects

Central aortic blood pressure and augmentation index during normal pregnancy

Influence of the Menstrual Cycle, Pregnancy, and Preeclampsia on Arterial Stiffness

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