Document Detail


Ophthalmic artery-resistive index and evidence of overperfusion-related encephalopathy in severe preeclampsia.
MedLine Citation:
PMID:  19948984     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Neurological findings in preeclampsia fulfill diagnostic criteria of posterior reversible encephalopathy syndrome (PRES), which is related to cerebral autoregulation impairment associated with high blood pressure. In preeclampsia, PRES may occur without a significant increase in blood pressure. Our aim was to investigate the association between ophthalmic artery resistive index (OARI) and clinical evidence of PRES, defined as the presence of headache and blurred vision, in patients with severe preeclampsia. OARI and main clinical and laboratory parameters were obtained in 112 patients with severe preeclampsia. Differences in these parameters were analyzed in the function of clinical evidence of PRES with a 2-sample t test. The area under receiver operating characteristic curve for each of these parameters in the function of clinical evidence of PRES was obtained. Logistic regression models were established with parameters categorized by cutoff points obtained in receiver operating characteristic curves. Among 112 patients with severe preeclampsia, 46 (41%) presented clinical evidence of PRES. These patients presented lower OARI (P<0.0001), higher mean blood pressure at admission (P<0.0001), higher mean blood pressure elevation after the first trimester (P<0.0001), and higher lactate dehydrogenase (P<0.0001) than those without clinical evidence of PRES. OARI presented an area under receiver operating characteristic curve of 0.810+/-0.039 (95% CI: 0.742 to 0.895; P<0.0001). OARI <0.56 was associated with clinical evidence of PRES, with an odds ratio of 12.67 (95% CI: 4.08 to 39.39; P<0.0001). Data suggest that OARI is a relevant biomarker of PRES in severe preeclampsia.
Authors:
Alexandre Simões Barbosa; Alamanda Kfoury Pereira; Zilma Silveira Nogueira Reis; Eura Martins Lage; Henrique Vitor Leite; Antônio Carlos Vieira Cabral
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-11-30
Journal Detail:
Title:  Hypertension     Volume:  55     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-18     Completed Date:  2010-01-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  189-93     Citation Subset:  IM    
Affiliation:
Departments of Gynecology and Obstetrics, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. alexandre.oftalmo@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Pressure / physiology*
Brain Diseases / complications,  diagnosis,  physiopathology*
Female
Headache / diagnosis,  etiology
Humans
Hypertension / physiopathology
L-Lactate Dehydrogenase / blood
Logistic Models
Multivariate Analysis
Ophthalmic Artery / physiopathology*
Platelet Count
Pre-Eclampsia / blood,  pathology,  physiopathology*
Pregnancy
ROC Curve
Severity of Illness Index
Syndrome
Ultrasonography, Doppler, Color
Vision Disorders / diagnosis,  etiology
Young Adult
Chemical
Reg. No./Substance:
EC 1.1.1.27/L-Lactate Dehydrogenase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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