Normal pregnancy is associated with enhanced  endothelium-dependent flow-mediated vasodilation

Dørup, I; Skajaa, Kristjar; Sørensen, Keld E.

doi:10.1152/ajpheart.1999.276.3.h821

Cited by 100 publications

(121 citation statements)

References 28 publications

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“…The results of this study confirm previous reports in pregnancy at sea level that described a substantial increase in flow-mediated dilatation of the brachial artery in the first two trimesters compared with non-pregnant controls 10,11 and a subsequent reduction in the third trimester 10 . It also corroborates the progressive increase in vessel size and resting blood flow with advancing gestation and the inverse relationship between flow-mediated dilatation and vessel size 10 .…”

Section: Discussionsupporting

confidence: 91%

Flow-mediated dilatation of the brachial artery in pregnancy at high altitude

Kametas¹

2002

BJOG: An International Journal of Obstetrics and Gynaecology

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Objective Pregnancy at high altitude has been associated with increased prevalence of pre-eclampsia and reduced maternal oestrogen levels, factors that have been associated with endothelial dysfunction. The aim of this study was to examine the effect of high altitude (4370 m above sea level) on endothelial function during pregnancy as assessed by a non-invasive method. Design Cross-sectional study.Setting Two maternity units providing routine antenatal care: one at high altitude (District General Hospital -IPSS in Cerro de Pasco, Peru) and one at sea level (Instituto Materno-Perinatal in Lima, Peru). Population Sixty pregnant women at 6 -42 weeks of gestation resident at high altitude (Cerro de Pasco, Peru, 4370 m above sea level) and 54 at sea level (Lima, Peru). Comparisons were performed also in 11 and 14 non-pregnant women at each altitude, respectively. Methods Endothelial function was assessed by flow-mediated dilatation of the brachial artery using highresolution ultrasound. Main outcome measures Differences in flow mediated dilatation of the brachial artery in two groups of pregnant women, one at high altitude and one at sea level. Results Both at high altitude and sea level flow-mediated dilatation of the brachial artery increased in the first two trimesters to levels 32% higher than non-pregnant controls. However, in the third trimester, flowmediated dilatation of the brachial artery was lower than non-pregnant levels. Resting vessel size increased during pregnancy by 15% compared with non-pregnant controls at term, with no difference between the two populations at high and low altitude. Pregnancy at high altitude, compared with sea level, was associated with 59% lower baseline blood flow and 76% higher reactive hyperaemia. Similarly, non-pregnant controls at high altitude compared with sea level demonstrated similar flow-mediated dilatation of the brachial artery and 40% lower resting blood flow of the brachial artery. However, the difference in reactive hyperaemia did not reach statistical significance. Conclusion These data suggest that, during pregnancy at high altitude, endothelial function, as assessed by flow-mediated dilatation of the brachial artery, is not impaired.

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Section: Discussionsupporting

confidence: 91%

Flow-mediated dilatation of the brachial artery in pregnancy at high altitude

Kametas¹

2002

BJOG: An International Journal of Obstetrics and Gynaecology

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“…25 Recent reports also show that normal pregnancy enhances flowmediated dilation in brachial artery with conflicting results on resting vessel diameters. 26,27 Our results agree with these findings; flow-mediated dilation in normotensive patients was significantly greater than that in nonpregnant women, whereas flow-mediated dilation in the subsequently developed pre-eclampsia patients was impaired (Table 2). We thus speculate that some intrinsic dysfunction might play an important role in the changes in vasoreactivity in pre-eclampsia.…”

Section: Discussionsupporting

confidence: 89%

Flow-mediated dilation in brachial artery in the second half of pregnancy and prediction of pre-eclampsia

et al. 2003

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Endothelial injury and increased vascular reactivity are involved in the pathogenesis of pre-eclampsia (pregnancy-induced hypertension). To investigate whether flow-mediated dilation (endothelium-dependent dilation) and the reactive hyperemic response can predict preeclampsia, we prospectively measured flow-mediated dilation and the Doppler flow velocity pattern (V, cm/s) in the brachial artery using high-resolution ultrasound in 43 pregnant women (32 7 5 years old) in the second half of their pregnancy, and compared the findings with traditional risk factors. Regarding the Doppler flow velocity pattern, the pulsatility index (PI) ¼ (systolic VÀdiastolic V)/mean V and resistance index (RI) ¼ (systolic VÀdiastolic V)/systolic V were calculated. For the flow-mediated dilation, the per cent diameter changes were determined based on those from baseline to hyperemic conditions. Nine women suffered from preeclampsia and 34 women remained normotensive. Only flow-mediated dilation was found to be significantly lower in the subsequently developed pre-eclampsia patients (1.6 7 1.0% in subsequently developed preeclampsia patients vs 11.0 7 4.5% in normotensive patients, Po0.05). Neither the other traditional factors nor the Doppler flow velocity pattern were significantly different between the subsequently developed preeclampsia and normotensive patients. If a normal cutoff value of 3.0% obtained from age-matched 14 nonpregnant women (32 7 7 years old) in our laboratory was used, the positive predictive value of flow-mediated dilation (o3.0%) for subsequent pre-eclampsia is 90% and the negative predictive value is 100%. In conclusion, flow-mediated dilation in brachial artery can be a simple and noninvasive modality to predict pre-eclampsia.

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“…6,20 In pregnancy, peripheral vascular resistance falls, blood volume expands and cardiac output increases, thus increasing the flow in the systemic and pulmonary circulations. 21 The increase in brachial artery diameter at rest may be caused by increased blood flow and thus increased shear stress, which is stimulus for endothelial NO release.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy-Related Hyperlipidemia and Endothelial Function in Healthy Women

Saarelainen

Laitinen

Raitakari

et al. 2006

Circ J

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BackgroundThe purpose of the present study was to investigate pregnancy-related changes in the maternal serum lipid profile and endothelial function. Methods and ResultsAs part of the population-based, prospective cohort Cardiovascular Risk in Young Finns study conducted in Finland, 57 pregnant Finnish women and 62 control women matched for age and smoking were examined throughout gestation. Serum triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were determined and concomitantly endothelium-dependent brachial artery flow mediated dilation (FMD) was measured by ultrasound. During pregnancy serum TC, LDL-C, HDL-C, TG and very-low-density lipoprotein cholesterol increased significantly when compared with the non-pregnant state (p<0.001 for each) and towards the end of pregnancy (p<0.001, p<0.001, p=0.007, p<0.001, p<0.001). FMD increased towards the end of pregnancy and there was a statistically significant direct correlation between gestational age and FMD% (r=0.345, p=0.010). Brachial artery diameter at rest and FMD% were negatively correlated in pregnant (r=-0.280, p=0.035) and non-pregnant women (r=-0.360, p<0.004). The univariate correlation analysis showed a direct correlation between maternal serum TC (r=0.333, p=0.012) and TG (r=0.366, p=0.006) and FMD%, whereas a negative non-significant correlation was found in non-pregnant women. In a multivariate model, vessel size ( =-0.436, p=0.001) and TG ( =0.502, p<0.001) were the most powerful predictors for FMD% in pregnancy, the influence of other lipids was non-significant. Conclusions In healthy pregnant women increased gestational age is associated with improved endothelium-dependent vasodilation responses regardless of concurrently appearing lipid changes. (Circ J 2006; 70: 768 -772)

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Normal pregnancy is associated with enhanced endothelium-dependent flow-mediated vasodilation

Cited by 100 publications

References 28 publications

Flow-mediated dilatation of the brachial artery in pregnancy at high altitude

Flow-mediated dilatation of the brachial artery in pregnancy at high altitude

Flow-mediated dilation in brachial artery in the second half of pregnancy and prediction of pre-eclampsia

Pregnancy-Related Hyperlipidemia and Endothelial Function in Healthy Women

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