Document Detail

Evidence of impaired microvascular function in pre-eclampsia: a non-invasive study.
MedLine Citation:
PMID:  12653685     Owner:  NLM     Status:  MEDLINE    
The clinical presentation of pre-eclampsia suggests that microvascular dysfunction may play a role in the maternal manifestations of the disease. Isovolumetric venous pressure ( P V(i)) is an index of microvascular function, reflecting local plasma colloid osmotic (oncotic) pressure, and is abnormal in clinical conditions with microvascular dysfunction. We hypothesized that, in pre-eclampsia, post-capillary margination of neutrophils would increase post-capillary resistance, and therefore P V(i). A small cumulative step strain-gauge plethysmography protocol was used to compare P V(i) in 18 women with pre-eclampsia, 16 normal pregnant women and 17 non-pregnant controls. Circulating levels of vascular cell-adhesion molecule-1 (VCAM-1), intercellular cell-adhesion molecule-1 (ICAM-1) and E-selectin, and neutrophil elastase, were measured to assess endothelial and neutrophil activation respectively. P V(i) was significantly greater in the pre-eclampsia group, relative to the normal pregnant and non-pregnant controls ( P <0.001, ANOVA, for both comparisons). P V(i) was significantly lower during normal pregnancy compared with the non-pregnant controls ( P =0.001). Plasma levels of neutrophil elastase, VCAM-1, ICAM-1 and E-selectin ( P =0.001) were significantly greater in the pre-eclamptics than the controls. Significant positive correlations were observed between P V(i) and neutrophil elastase ( r =0.71, P =0.001), VCAM-1 ( r =0.52, P =0.03), ICAM-1 ( r =0.67, P =0.002), E-selectin ( r =0.69, P =0.001), uric acid levels ( r =0.54, P =0.02) and haematocrit ( r =0.64, P =0.004) in pre-eclampsia. The relationship with the platelet count was negative ( r =-0.65, P =0.003). No significant correlations were observed between P V(i) and maternal age, gestational age, total protein, albumin, diastolic blood pressures, age, body mass index and infant birth mass in the normal pregnant and non-pregnant controls. These data suggest that microvascular dysfunction occurs in pre-eclampsia, and that it is related to alterations in endothelial cell and neutrophil activation.
N Anim-Nyame; J Gamble; S R Sooranna; M R Johnson; M H Sullivan; P J Steer
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical science (London, England : 1979)     Volume:  104     ISSN:  0143-5221     ISO Abbreviation:  Clin. Sci.     Publication Date:  2003 Apr 
Date Detail:
Created Date:  2003-03-25     Completed Date:  2003-07-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7905731     Medline TA:  Clin Sci (Lond)     Country:  England    
Other Details:
Languages:  eng     Pagination:  405-12     Citation Subset:  IM    
Department of Maternal and Fetal Medicine, Imperial College School of Medicine at Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, U.K.
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MeSH Terms
Case-Control Studies
E-Selectin / blood
Endothelium, Vascular / metabolism
Intercellular Adhesion Molecule-1 / blood
Leukocyte Elastase / blood
Neutrophil Activation
Placental Circulation*
Pre-Eclampsia / blood,  immunology,  physiopathology*
Regression Analysis
Uric Acid / blood
Vascular Cell Adhesion Molecule-1 / blood
Venous Pressure*
Reg. No./Substance:
0/E-Selectin; 0/Vascular Cell Adhesion Molecule-1; 126547-89-5/Intercellular Adhesion Molecule-1; 69-93-2/Uric Acid; EC Elastase
Comment In:
Clin Sci (Lond). 2003 Apr;104(4):413-4   [PMID:  12653686 ]

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