The relationship between brachial artery flow‐mediated dilatation, high sensitivity C‐reactive protein, and uterine artery doppler velocimetry in women with pre‐eclampsia

Adalı, Ertan; Kurdoğlu, Mertihan; Adali, Fulya; Çim, Numan; Yıldızhan, Recep; Kolusarı, Ali

doi:10.1002/jcu.20781

Cited by 20 publications

(20 citation statements)

References 31 publications

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“…The 14 cross-sectional studies that were eligible for the meta-analysis 23, 30–41 included 333 preeclamptic women and 467 non-preeclamptic pregnant women (Tables S2, S6). Five additional studies were included in the qualitative synthesis.…”

Section: Resultsmentioning

confidence: 99%

Impaired Flow-Mediated Dilation Before, During, and After Preeclampsia

et al. 2016

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Endothelial dysfunction is believed to play a critical role in preeclampsia, however it is unclear whether this dysfunction precedes the pregnancy or is caused by early pathophysiological events. It is also unclear for how long vascular dysfunction may persist post-partum, and whether it represents a mechanism linking preeclampsia with future cardiovascular disease. Our objective was to determine whether women with preeclampsia have worse vascular function compared to women who did not have preeclampsia by performing systematic review and meta-analysis of studies that examined endothelial dysfunction using flow-mediated dilation (FMD). We included studies published before May 29, 2015 that examined FMD before, during and after preeclampsia. Differences in FMD between study groups were evaluated by standardized mean differences. Out of 610 abstracts identified through PubMED, EMBASE and Web of Science, 37 studies were eligible for the meta-analysis. When compared to women who did not have preeclampsia, women who had preeclampsia had lower FMD prior to the development of preeclampsia (~20–29 weeks gestation), at the time of preeclampsia, and for three years post-partum, with the estimated magnitude of the effect ranging between 0.5 and 3 standard deviations. Similar effects were observed when the analysis was limited to studies that excluded women with chronic hypertension, smokers, or both. Vascular dysfunction predates preeclampsia and may contribute to its pathogenesis. Future studies should address whether vascular changes that persist after preeclamptic pregnancies may represent a mechanistic link with the increased risk for future cardiovascular disease.

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Section: Resultsmentioning

confidence: 99%

Impaired Flow-Mediated Dilation Before, During, and After Preeclampsia

et al. 2016

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“…In pre-eclamptic pregnancies complicated by IUGR, FMD is further reduced [44, 48]. FMD is a non-invasive marker of endothelial function and, as such, NO bioavailability.…”

Section: Effect Of Gsnor Inhibitors On Endothelial Functionmentioning

confidence: 99%

Pre-eclampsia: the Potential of GSNO Reductase Inhibitors

2017

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Purpose of ReviewPre-eclampsia remains a leading worldwide cause of maternal death and of perinatal morbidity. There remains no definitive treatment except delivery of the fetus.Recent FindingsRecent insights into the cardiovascular changes that are evident prior to, during, and persist after pre-eclampsia have improved understanding of the underlying pathophysiology—disruption of normal endothelial function and decreased nitric oxide bioavailability. S-nitrosoglutathione (GSNO) is an endogenous S-nitrosothiol that acts as a NO pool and, by replenishing or preventing the breakdown of GSNO, endothelial dysfunction can be ameliorated. GSNO reductase inhibitors are a novel class of drug that can increase NO bioavailability.SummaryGSNO reductase inhibitors have demonstrated improvement of endothelial dysfunction in animal models, and in vivo human studies have shown them to be well tolerated. GSNOR inhibitors offer a potentially promising option for the management of pre-eclampsia.

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“…Most studies report lower FMD in women with preeclampsia, compared to normotensive pregnant women [70, 66, 71, 72, 65, 52, 76, 77]. However, a few studies found no differences [67, 61, 68].…”

Section: Fmd and Preeclampsiamentioning

confidence: 99%

“…FMD was lower in women with preeclampsia complicated by HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome, eclampsia or stillbirth, compared to women who had preeclampsia without these complications [78]. FMD was also lower in preeclamptic women with an abnormal uterine artery Doppler at diagnosis, compared to preeclamptic women with a normal uterine artery Doppler [66]. However, FMD did not differ among women with normotensive pregnancies, mild preeclampsia and severe preeclampsia [67], or between women with preeclampsia and women with preeclampsia superimposed on chronic hypertension [79].…”

Section: Fmd and Preeclampsiamentioning

confidence: 99%

Flow-Mediated Dilation: Can New Approaches Provide Greater Mechanistic Insight into Vascular Dysfunction in Preeclampsia and Other Diseases?

Weissgerber

2014

Curr Hypertens Rep

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Endothelial dysfunction is a key feature of preeclampsia, and may contribute to increased cardiovascular disease risk years after pregnancy. Flow-mediated dilation (FMD) is a non-invasive endothelial function test that predicts cardiovascular event risk. New protocols allow researchers to measure three components of the FMD response: FMD, low flow-mediated constriction and the shear stimulus. This review encourages researchers to think beyond “low FMD” by examining how these three components may provide additional insights into the mechanisms and location of vascular dysfunction. The review then examines what FMD studies reveal about vascular dysfunction in preeclampsia, while highlighting opportunities to gain greater mechanistic insight from new protocols. Studies using traditional protocols show that FMD is low in mid-pregnancy prior to preeclampsia, at diagnosis, and for three years post-partum. However, FMD returns to normal by ten years post-partum. Studies using new protocols are needed to gain more mechanistic insight.

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The relationship between brachial artery flow‐mediated dilatation, high sensitivity C‐reactive protein, and uterine artery doppler velocimetry in women with pre‐eclampsia

Abstract: These findings suggest that maternal serum hs-CRP levels increase with the severity of pre-eclampsia, reflecting endothelial dysfunction and constituting a potential marker of pathological utero-placental perfusion, with a high risk for fetal growth restriction.

Cited by 20 publications

References 31 publications

Impaired Flow-Mediated Dilation Before, During, and After Preeclampsia

Impaired Flow-Mediated Dilation Before, During, and After Preeclampsia

Pre-eclampsia: the Potential of GSNO Reductase Inhibitors

Flow-Mediated Dilation: Can New Approaches Provide Greater Mechanistic Insight into Vascular Dysfunction in Preeclampsia and Other Diseases?

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