Plasma endothelin, atrial natriuretic peptide (ANP) and uterine and umbilical artery flow velocity waveforms in hypertensive pregnancies

Abstract

Objective To investigate the relation between concentrations of endothelin and atrial natriuretic peptide (ANP) in maternal plasma and vasospasm in the uterine and umbilical arteries as detected by duplex pulsed colour Doppler ultrasonography in hypertensive pregnancies.Design An observational study.Subjects 32 women admitted consecutively to hospital with pregnancy induced hypertension (seven without proteinuria and 25 with proteinuria) and 78 healthy pregnant women examined at 28–0 weeks gestation.Main outcome measures Systolic/diastolic (S/D) ratio in flow velocity waveforms (FVWs) and plasma concentrations of endothelin and ANP in the 32 women with pregnancy induced hypertension; plasma concentrations of endothelin and ANP in 78 healthy pregnant women (controls).Results Pathological FVWs suggesting vasospasm in the uterine or umbilical artery, or both arteries, were found in 12 women with hypertension. Plasma ANP was significantly higher (P= 0.03) in the women with hypertension and pathological FVWs (median 23.0, range 10.1–52.8 pmol/1) than in those with hypertension and normal FVWs, (median 13.8, range 5.3–42.3 pmol/1) but corresponding plasma endothelin levels did not show any significant difference (median 1.63, range 0.51–3.33 pmol/1 and median 1.38, range 0.51–3.51 pmol/1, respectively).Conclusion Local release of endothelin from the vascular endothelium is thought to cause vasospasm in pregnancy induced hypertension but this does not seem to increase the concentration of endothelin in the maternal peripheral plasma, probably because of its rapid disappearance from the blood circulation. As ANP dilates the blood vessels, the increase of its release in hypertensive pregnancies may be a compensatory mechanism against vasospasm.

Endothelin-1-like immunoreactivity and endothelin receptors in the human placenta from normotensive and hypertensive pregnancies

“…We and others have reported previously that plasma ET-1-LI levels in pregnant women with PIH are elevated compared with those in the normotensive pregnant women [5,11,13,17,20,28,32], although several investigators have reported contradictory results [3,16]. In the present study, ET-1-LI levels in the umbilical venous plasma of newborns from PIH women were also higher than those in newborns from normotensive pregnant women.…”

Maternal EDN1 G5665T polymorphism influences circulating endothelin-1 levels and plays a role in determination of preeclampsia phenotype

“…Several studies have shown increased plasma ET-1 concentrations in preeclampsia [16][17][18][19], but some have failed to find such an association [20,21]. In one study [22], first trimester ET-1 levels could predict preeclampsia with high sensitivity.…”

Peripartal Temporal Course of Endothelin 1, Angiotensin II, and Atrial Natriuretic Peptide in Pre-Eclampsia and Normotensive Pregnancy

“…In interference with relaxation factors, ET-1 plays an important role in regulating blood flow and blood pressure [17,18]. Previous reports on ET-1 concentrations in peripheral maternal plasma in patients with pre-eclampsia have been contradictory, some showing increased [4][5][6] and some normal values [7,8].…”