Peripheral arterial pulse wave analysis in women with pre‐eclampsia and gestational hypertension

Spasojevic, Mica; Smith, Simone; Morris, Jonathan M.; Gallery, Eileen D.M.

doi:10.1111/j.1471-0528.2005.00701.x

Cited by 74 publications

(53 citation statements)

References 11 publications

(16 reference statements)

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“…25 Recent studies using PWA have confirmed reduced arterial compliance (in other words, increased arterial stiffness) in women with clinically established pre-eclampsia. 21,23,24 Our aims were to investigate whether PWA could identify an increase in arterial stiffness in advance of clinically evident pre-eclampsia and to provide preliminary information on whether the technique might be used to predict the disease.…”

Section: Introductionmentioning

confidence: 99%

“…This technique has been widely studied in the nonpregnant population, [13][14][15][16][17][18][19] but studies in pregnancy are limited. [20][21][22][23][24] Pulse wave analysis (PWA) can quantify alterations in vascular compliance associated with conditions that cause endothelial dysfunction, such as diabetes, renal disease and arteriosclerosis. The technique is noninvasive and easy to learn.…”

Section: Introductionmentioning

confidence: 99%

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Pulse wave analysis: a preliminary study of a novel technique for the prediction of pre‐eclampsia

Khalil

Cooper

Harrington

2008

BJOG

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Objective To investigate whether first-trimester arterial pulse wave analysis (PWA) can predict pre-eclampsia.Design This was a prospective screening study.Setting The Homerton University Hospital, a London teaching hospital.Population Two hundred and ten low-risk women with a singleton pregnancy were analysed.Methods Radial artery pulse waveforms were measured between the 11 +0 and 13 +6 weeks of gestation and the aortic waveform derived by applying a generalised transfer function. Augmentation pressure (AP) and augmentation index at heart rate of 75 beats per minute (AIx-75), measures of arterial stiffness, were calculated. The multiple of the gestation-specific median in controls for AP and AIx-75 were calculated. Logistic regression models were developed and their predictive ability assessed using the area under the receiver operator curve.Main outcome measures Prediction of pre-eclampsia by AIx-75.Results Fourteen (6.7%) women developed pre-eclampsia, and 196 remained normotensive. Eight of the 14 women developed pre-eclampsia before 34 weeks of gestation (early-onset pre-eclampsia). For a false-positive rate of 11%, AIx-75 had a detection rate of 79% for all cases of pre-eclampsia and 88% for early-onset pre-eclampsia.Conclusion First-trimester arterial PWA can play a significant role in understanding the pathophysiology of pre-eclampsia and may play a role in early screening.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pulse wave analysis: a preliminary study of a novel technique for the prediction of pre‐eclampsia

Khalil

Cooper

Harrington

2008

BJOG

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“…6 -11 However, data are conflicting concerning the effect of sex steroids on arterial stiffness during the menstrual cycle 12,13 and the effect of later gestation. 14,15 Augmentation index and pulse wave velocity (PWV) are the principal measures of central arterial pressure and stiffness that can be determined noninvasively using applanation tonometry. Within normotensive pregnancy, PWV is more closely associated with birth weight than mean arterial pressure, suggesting that arterial stiffness may represent maternal adaptation to pregnancy better than blood pressure.…”

mentioning

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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“…В последнее время в зарубежной ли-тературе появились новые сведения о значении показате-лей центрального АД и ригидности артерий, измеренных с помощью неинвазивных методов у беременных. Иссле-дования показали, что у беременных с ПЭ отмечалось по-вышение жесткости артерий и центрального АД по срав-нению с таковыми у женщин с ГАГ и нормально протека-ющей беременностью [9,16,17]. Повышение ригидности артерий тесно взаимосвязано с дисфункцией эндотелия [18,19].…”

Section: Discussionunclassified

“…В последнее время в литературе появляются новые сведения о значении показателей центрального (аорталь-ного) артериального давления (АД) и ригидности артерий у беременных с АГ, особенно с ПЭ [6][7][8]. При развитии ПЭ повышение жесткости артерий на фоне дисфункции эндотелия в сочетании с вазоконстрикцией приводит к повышению общего периферического сопротивления со-судов, что способно ухудшить кровообращение в маточ-но-плацентарном бассейне и системную гемодинамику у матери [9,10]. Неинвазивная оценка показателей цен-трального (аортального) АД и состояния ригидности арте-рий во время беременности позволяет оптимизировать прогнозирование осложнений, связанных с АГ.…”

Section: контактная информацияunclassified

Estimation of central blood pressure and arterial stiffness in pregnant women with different forms of hypertension

Чулков¹,

Vereina²,

Sp³

et al. 2014

Ter. arkh.

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РезюмеЦель исследования. Оценить показатели центрального (аортального) артериального давления (АД) и ригидности артерий и их прогностическую значимость в отношении развития преэклампсии (ПЭ) у беременных с различными формами артериальной гипертонии (АГ). Материалы и методы. В исследование включили 106 пациенток с хронической АГ, 21 пациентку с хронической АГ и присоединившейся ПЭ, 63 пациентки с гестационной АГ, 10 пациенток с ПЭ и 100 женщин без АГ. Всем женщинам выполнено суточное мониторирование АД осциллометрическим методом измерения с определением центрального (аортального) АД и параметров ригидности артерий на сроках 16-22 нед беременности. Результаты. У беременных с ПЭ оказались наиболее высокие показатели среднесуточного центрального систолического и диастолического АД. Наиболее значимым для прогнозирования ПЭ по результатам ROC-анализа явилось среднесуточное аортальное систолическое АД выше 115 мм рт.ст. У беременных с ПЭ на фоне хронической АГ выявлены наиболее высокие показатели ригидности артерий (индекс аугментации, индекс ригидности, максимальная скорость нарастания АД). Заключение. Проведение суточного мониторирования АД у беременных позволяет получить дополнительные характеристики, отражающие ригидность аорты и периферических артерий, которые могут использоваться для прогнозирования ПЭ.Ключевые слова: артериальная гипертония, беременность, центральное (аортальное) артериальное давление, ригидность артерий.Aim. To estimate central (aortic) blood pressure (BP) and arterial stiffness and their prognostic value in the development of preeclampsia (PE) in pregnant women with different forms of hypertension. Subjects and methods. The study included 106 patients with chronic hypertension, 21 with the latter concurrent with PE, 63 with gestational hypertension, 10 with PE, and 100 without hypertension. All the women underwent 24-hour BP monitoring by an oscillometric method to estimate central (aortic) BP and arterial stiffness at 16-22 weeks' gestation. Results. The highest average daily central systolic and diastolic BP was in the pregnant women with PE. ROC analysis showed that the average daily aortic systolic BP greater than 115 mm Hg was most significant for the prediction of PE. The highest values of arterial stiffness (augmentation index, stiffness, maximum rate of blood pressure rise) were detected in the pregnant women with PE in the presence of chronic hypertension. Conclusion. 24-four BP monitoring in pregnant women can provide additional characteristics that reflect the stiffness of the aorta and peripheral arteries, which may be used to predict PE. Key words: hypertension, pregnancy, central (aortic) blood pressure, arterial stiffness.АГ -артериальная гипертония АД -артериальное давление ГАГ -гестационная АГ ДАД -диастолическое АД ДИ -доверительный интервал ПЭ -преэклампсия САД -систолическое АД СМАД -суточное мониторирование АД ХАГ -хроническая АГ +LR -прогностическая ценность положительного результата AASI -амбулаторный индекс ригидности жесткости артерий AIx 75 (augmentation index) -индек...

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Peripheral arterial pulse wave analysis in women with pre‐eclampsia and gestational hypertension

Abstract: Non-invasive applanation tonometry discriminates among normal pregnancy, GH and PE, and may be useful to predict PE.

Cited by 74 publications

References 11 publications

Pulse wave analysis: a preliminary study of a novel technique for the prediction of pre‐eclampsia

Pulse wave analysis: a preliminary study of a novel technique for the prediction of pre‐eclampsia

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

Estimation of central blood pressure and arterial stiffness in pregnant women with different forms of hypertension

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