Document Detail


Prospective study of placental angiogenic factors and maternal vascular function before and after preeclampsia and gestational hypertension.
MedLine Citation:
PMID:  20644016     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Preeclampsia is a life-threatening pregnancy syndrome of uncertain origin. To elucidate the pathogenesis, we evaluated the temporal relationships between changes in vascular function and circulating biomarkers of angiogenic activity before and after the onset of preeclampsia and gestational hypertension.
METHODS AND RESULTS: Maternal mean arterial pressure, uterine artery pulsatility index, brachial artery flow-mediated dilatation, and serum concentrations of placental growth factor (PlGF), soluble fms-like tyrosine kinase 1 (sFlt-1), and soluble endoglin were prospectively measured in 159 women from 10 weeks gestation until 12 weeks postpartum. At 10 to 17 weeks, women who developed preterm preeclampsia had lower serum PlGF (P=0.003), higher soluble endoglin (P=0.006), and higher sFlt-1:PlGF ratio (P=0.005) compared with women who later developed term preeclampsia, gestational hypertension, or normotensive pregnancy. At 10 to 17 weeks, mean arterial pressure inversely correlated with serum PlGF (r=-0.19, P=0.02); at 18 to 25 weeks, with soluble endoglin (r=0.18, P=0.02); and at 26 to 33 weeks, with sFlt-1 (r=0.28, P<0.001). At 23 to 25 weeks, uterine artery pulsatility index correlated with serum soluble endoglin (r=0.19, P=0.02) and sFlt-1 levels (r=0.17, P=0.03). Flow-mediated dilatation was higher during a pregnancy with gestational hypertension compared with preeclampsia (P=0.001). Twelve weeks postpartum, serum PlGF was higher in women who had a hypertensive pregnancy compared with a normotensive pregnancy (P<0.001).
CONCLUSIONS: These observations support a role for placenta-derived angiogenic biomarkers in the control of maternal vascular resistance of preeclampsia. Gestational hypertension develops differently, with a hyperdynamic circulation and angiogenic biomarker profile similar to normotensive pregnancy. Larger studies of unselected women are needed to ascertain whether measures of these angiogenic biomarkers assist with the prediction and prognosis of preeclampsia and whether postpartum measures of serum PlGF have a role in predicting future cardiovascular disease.
Authors:
Muna Noori; Ann E Donald; Aspasia Angelakopoulou; Aroon D Hingorani; David J Williams
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-07-19
Journal Detail:
Title:  Circulation     Volume:  122     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-03     Completed Date:  2010-09-08     Revised Date:  2011-10-26    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  478-87     Citation Subset:  AIM; IM    
Affiliation:
Division of Surgery, Imperial College, Chelsea and Westminster Hospital, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Antigens, CD / blood
Biological Markers / blood*
Blood Pressure / physiology
Brachial Artery / physiology
Female
Humans
Hypertension, Pregnancy-Induced / blood*,  epidemiology
Neovascularization, Physiologic / physiology*
Pre-Eclampsia / blood*,  epidemiology
Pregnancy
Pregnancy Outcome / epidemiology
Pregnancy Proteins / blood
Prospective Studies
Pulsatile Flow / physiology
Receptors, Cell Surface / blood
Risk Factors
Uterine Artery / physiology
Vascular Endothelial Growth Factor Receptor-1 / blood
Chemical
Reg. No./Substance:
0/Antigens, CD; 0/Biological Markers; 0/ENG protein, human; 0/Pregnancy Proteins; 0/Receptors, Cell Surface; 144589-93-5/placenta growth factor; EC 2.7.10.1/FLT1 protein, human; EC 2.7.10.1/Vascular Endothelial Growth Factor Receptor-1
Comments/Corrections
Erratum In:
Circulation. 2011 Sep 13;124(11):e302

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


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