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首页> 外文期刊>Circulation: An Official Journal of the American Heart Association >Vascular dysfunction in women with a history of preeclampsia and intrauterine growth restriction: insights into future vascular risk.
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Vascular dysfunction in women with a history of preeclampsia and intrauterine growth restriction: insights into future vascular risk.

机译：有先兆子痫和子宫内生长受限史的女性的血管功能障碍：对未来血管风险的见解。

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BACKGROUND: Women with a history of placental disease are at increased risk for the future development of vascular disease. It is unknown whether preexisting endothelial dysfunction underlies both the predisposition to placental disease and the later development of vascular disease. The aim of this study was to assess vascular function in postpartum women and to determine whether differences emerged depending on the presentation of placental disease. METHODS AND RESULTS: Women with a history of early-onset preeclampsia (n=15), late-onset preeclampsia (n=9), intrauterine growth restriction without preeclampsia (n=9), and prior normal pregnancy (n=16) were studied 6 to 24 months postpartum. Flow-mediated vasodilatation and flow-independent (glyceryl trinitrate-induced) vasodilatation were studied through the use of high-resolution vascular ultrasound examination of the brachial artery. Arterial stiffness was assessed by pulse-wave analysis (augmentation index). Laboratory assessment included circulating angiogenic factors (vascular endothelial growth factor, soluble fms-like tyrosine kinase 1, placental growth factor, and soluble endoglin). Flow-mediated vasodilatation was significantly reduced in women with previous early-onset preeclampsia and intrauterine growth restriction compared with women with previous late-onset preeclampsia and control subjects (3.2+/-2.7% and 2.1+/-1.2% versus 7.9+/-3.8% and 9.1+/-3.5%, respectively; P<0.0001). Flow-independent vasodilatation was similar among all groups. Similarly, the radial augmentation index was significantly increased among women with previous early-onset preeclampsia and intrauterine growth restriction, but not among late preeclamptic women and control subjects (P=0.0105). Circulating angiogenic factors were similar in all groups. CONCLUSION: Only women with a history of early-onset preeclampsia or intrauterine growth restriction without preeclampsia exhibit impaired vascular function, which might explain their predisposition to placental disease and their higher risk of future vascular disease.
机译：背景：有胎盘疾病史的妇女患血管疾病的未来风险增加。尚不存在既往的内皮功能障碍是否是胎盘疾病的易感性和血管疾病的后期发展的基础。这项研究的目的是评估产后妇女的血管功能，并根据胎盘疾病的表现确定是否出现差异。方法和结果：具有早发型先兆子痫（n = 15），晚发型先兆子痫（n = 9），无先兆子痫的子宫内生长受限（n = 9）和既往正常妊娠（n = 16）的女性为研究了产后6至24个月。通过使用肱动脉高分辨率血管超声检查，研究了血流介导的血管舒张和血流无关（三硝酸甘油酯诱导的）血管舒张。通过脉搏波分析（增强指数）评估动脉僵硬度。实验室评估包括循环血管生成因子（血管内皮生长因子，可溶性fms样酪氨酸激酶1，胎盘生长因子和可溶性内皮糖蛋白）。与早发先兆子痫和宫内节育的女性相比，早发先兆子痫和宫内生长受限的女性的血流介导的血管舒张明显降低（3.2 +/- 2.7％和2.1 +/- 1.2％对7.9 +/-分别为3.8％和9.1 +/- 3.5％; P <0.0001）。在所有组中，与流量无关的血管舒张相似。同样，先前有早发先兆子痫和宫内生长受限的女性的augment骨增大指数显着增加，但先兆子痫前期妇女和对照组则没有（P = 0.0105）。在所有组中循环血管生成因子相似。结论：只有具有早发型先兆子痫或宫内生长受限史且无先兆子痫的女性，其血管功能受损，这可能解释了其易患胎盘疾病和未来发生血管疾病的较高风险。

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