Does mild preeclampsia cause arterial stiffness and ventricular remodeling through inflammation?
8
0
0
Tam metin
(2) Ginekol Pol. 2014, 85, 900-907. P R A C E. O R Y G I N A L N E g i n e kol og i a. Faika Ceylan Ciftci et al. Does mild preeclampsia cause arterial stiffness and ventricular remodeling through inflammation?. Streszczenie Wstęp: Istnieje powiązanie pomiędzy stanem przedrzucawkowym (PE) a nadmierną zachorowalnością i śmiertelnością. Ponadto, sugeruje się, że przewlekły stan zapalny udzielający się w PE przyczynia się do przyspieszenia miażdżycy. Istnieje również związek między PE przebudowy mięśnia sercowego ze strony matki i dwukomorową dysfunkcją rozkurczową. Zaplanowaliśmy ocenić w tym badaniu, czy nie została osłabiona wydolność mięśnia sercowego oraz zwiększenie sztywności tętnic u pacjentek, które pięć lat wcześniej miały łagodny przypadek PE. Metody: W badanie włączonych zostało czterdzieści pacjentek (40 kobiet; średnia wieku 33,75±7,95) oraz 27 zdrowych ochotniczek (27 kobiet: średnia wieku: 36,44±10,45). Każda z pacjentek została zbadana za pomocą echokardiografii przezklatkowej, w tym echokardiografii dopplerowskiej w połączeniu z tkankową echokardiografią dopplerowską (TDI). Zostały również zmierzone takie wartości, jak wskaźnik sztywności aorty (AoSI), rozciągliwość aorty, a także moduł sprężystości aorty (AoEM). Wyniki: Stwierdzono statystycznie istotny wzrost hsCRP, wskaźnika sztywności aorty i modułu sprężystości aorty u pacjentów z PE w porównaniu z grupą kontrolną (2,43±1,91vs. 3,80±2,06, p=0.007; 3,09±2,41 vs. 7,32±6,89, p=0,001; 2,89±2,11 vs. 7,00± 6,83, p=0,001), natomiast znaczne zmniejszenie zaobserwowano w odkształceniu aorty i jej rozciągliwości (odpowiednio 22,35±15,99 vs. 12,24±9,22, p= 0,005; 11,17±9,68 vs. 6,13±4,99, p=0.018). Nie wystąpiły różnice pomiędzy tymi dwoma grupami w odniesieniu do wskaźnika wydolności mięśnia sercowego lewej komory (0,55± 0,16 vs 0,53± 0,19, p=0,630). Wnioski: Stwierdziliśmy po raz pierwszy w tym badaniu, że wystąpiły osłabiona elastyczność aorty i niezmieniony wskaźnik wydolność mięśnia sercowego (MPI) u pacjentek z łagodnym PE, ponadto, efekty te były znacząco skorelowane ze stanem zapalnym.. Słowa kluczowe:
(3) / / / /. Introduction. Methods.
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11) causes of maternal morbidity and mortality, affecting between
(12)
(13)
(14)
(15)
(16) !
(17)
(18) "!
(19) #$
(20) #
(21)
(22) %
(23) !
(24) & '
(25) !
(26) !$
(27)
(28)
(29) $
(30)
(31)
(32) !
(33) $
(34) .
(35)
(36)
(37) '
(38) (
(39) !
(40) %
(41) ! !
(42) !
(43)
(44)
(45)
(46)
(47)
(48) )
(49)
(50) !%
(51) ! %
(52) !
(53)
(54)
(55) $
(56) * + '
(57) - !
(58)
(59) .
(60) !.
(61) ! !
(62)
(63) ! # $
(64)
(65) #
(66) /
(67)
(68) 0 ! !
(69) . '
(70) 3
(71) !4
(72)
(73)
(74) !
(75) #!
(76) .
(77) %
(78) !
(79) ! !
(80) $
(81) $
(82) !
(83) #%
(84) !
(85) !
(86) 5$
(87) .
(88)
(89) #
(90) . !
(91) 0
(92) !
(93)
(94) .
(95) 6 '
(96) 78
(97) ! # $
(98) 79-
(99) .
(100) !5
(101)
(102) AoEM(aortic elastic modulus), tissue Doppler echocardiography !
(103) $!
(104)
(105) !5 <-
(106)
(107) !
(108)
(109) . .
(110) different aspects of heart diseases. Each of these tests is already !!
(111)
(112) #
(113) ! %
(114)
(115) ! %
(116) %
(117) #
(118) #
(119)
(120) $
(121) $ !
(122)
(123) %
(124)
(125) ! %
(126) %'
(127) -
(128)
(129) !$
(130) 0
(131) !!
(132)
(133) !
(134) 0
(135) <-
(136) !
(137)
(138) .
(139) 0
(140) !
(141)
(142)
(143)
(144) 0
(145) ! %
(146) )
(147) '
(148) >
(149)
(150)
(151) !
(152)
(153) !
(154)
(155)
(156) . !
(157)
(158)
(159) #!
(160) .
(161) ?
(162)
(163) *@.B@
(164)
(165) I
(166)
(167)
(168) 0
(169)
(170)
(171) @'.!$
(172)
(173) <-
(174) !
(175)
(176) .
(177) 0
(178)
(179)
(180) !
(181)
(182) ! %
(183) !
(184)
(185) $
(186) !%
(187)
(188)
(189) $
(190) % !
(191) !
(192)
(193)
(194) )
(195)
(196) <-
(197) !
(198)
(199) stiffness measurements [8]. K
(200) .
(201) 0
(202)
(203)
(204) 0
(205)
(206)
(207)
(208)
(209) %
(210) ! %
(211)
(212) $
(213) !
(214)
(215)
(216) .
(217)
(218) well as to impaired myocardial systolic and diastolic functions.. Study population. Nr 12/2014. L
(219) !$
(220)
(221) !!
(222) *@
(223)
(224) !
(225) N*@
(226) 0
(227) !
(228) #
(229) / !
(230) 0
(231)
(232) %
(233) $
(234) % $'
(235) L
(236)
(237)
(238) . !
(239)
(240) &6
(241) $
(242) 0
(243) !
(244)
(245)
(246) !
(247) 0
(248) #
(249) ?<-
(250) ?!$
(251) <.
(252) -!5
(253) 0
(254)
(255) $
(256)
(257) $. !
(258) $ '
(259) (
(260)
(261) $
(262) !
(263) hypertension and hyperlipidemia, smoking, diabetes, glucose intolerance, thyroid dysfunction, chronic alcohol use, coronary $
(264) !
(265)
(266)
(267)
(268) !
(269) %%
(270)
(271) !
(272) !
(273) $
(274)
(275)
(276) !
(277) ?<-
(278) P
(279) ). &
(280)
(281)
(282)
(283) %
(284) .
(285) !5
(286) >Q<-
(287) P @
(288) .&
(289) $
(290) .
(291)
(292) $
(293) $
(294) !
(295) # !
(296) !
(297) %$
(298)
(299)
(300)
(301) !
(302)
(303) I>>
(304) $!
(305) #
(306) 6
(307) 0)
(308)
(309) pregnancy, constituted exclusion criteria from the study. The study was conducted according to the principles of the 8
(310)
(311) I ) '
(312) -!
(313)
(314) 0
(315) # !
(316)
(317)
(318). !$
(319)
(320) !
(321) >
(322)
(323) R
(324) %!
(325)
(326)
(327). !$
(328)
(329)
(330) S7@B.6&' 7
(331) !
(332) ?<-
(333) %
(334)
(335)
(336) #!
(337)
(338)
(339)
(340) "$
(341)
(342)
(343) !
(344)
(345)
(346) I8>
(347) >8>
(348) !
(349) $ !
(350)
(351)
(352) #4
(353) 0
(354) !!'
(355) V
(356)
(357) )
(358) 0
(359) 7##7
(360) $"
(361) R
(362) ->
(363) V97
(364)
(365) #!
(366)
(367)
(368)
(369) I8>
(370) >8>
(371) !
(372) $ !
(373) %
(374) 0
(375) !'
(376) V
(377)
(378) 7##7
(379) $"
(380) R
(381) ->
(382) V97
(383) !
(384)
(385) $
(386) %
(387) !0
(388)
(389) W
(390)
(391)
(392) %
(393)
(394) R %
(395)
(396) 0
(397)
(398) ! !'. Echocardiographic examination Each case was assessed using an Acuson Sequoia C256® ! $
(399) 9$
(400) W !
(401) 0
(402)
(403) Q&
(404) #!#!
(405). © Polskie Towarzystwo Ginekologiczne. 901.
(406) Ginekol Pol. 2014, 85, 900-907. P R A C E O R Y G I N A L N E ginekolog i a. Faika Ceylan Ciftci et al. Does mild preeclampsia cause arterial stiffness and ventricular remodeling through inflammation?. transducer with second harmonic capability (Acuson, Mountain Q 0
(407) R7
(408) V97'
(409) -
(410)
(411)
(412) !#
(413)
(414) 0 !
(415) <!
(416) !!
(417) !
(418) \ !^
(419) .
(420) 8
(421) echocardiography was performed in each subject. The !
(422)
(423) 0
(424) !!
(425)
(426) QI9
(427) % ! '
(428) L
(429)
(430) %
(431) .
(432) !5
(433) >Q<-
(434) !
(435)
(436) %
(437) 4
(438)
(439) _
(440) 0
(441) !
(442)
(443) %
(444) '
(445) V
(446)
(447) 8
(448) %
(449)
(450) 0
(451) )
(452)
(453)
(454)
(455) !
(456) !
(457) %%
(458) '
(459) $
(460) !
(461) )
(462) /0
(463) % $
(464)
(465)
(466) !
(467) )
(468) /0
(469) % $
(470)
(471) .7
(472)
(473) !
(474)
(475) 0%
(476) !
(477)
(478) 8L
(479) 0
(480) !
(481)
(482)
(483) 8
(484) '
(485) L
(486) L.
(487) 8
(488) -
(489) L8-
(490)
(491) 0
(492)
(493)
(494)
(495)
(496) 0%
(497) 8
(498) !'
(499) K
(500)
(501) were performed to show the regional systolic function. The !
(502) %
(503) !!
(504) )
(505) % $
(506) .
(507) % $
(508)
(509)
(510)
(511) $!
(512) $
(513) 0%
(514) 9
(515) $!
(516) $
(517)
(518) !
(519)
(520) 7
(521) )
(522) %
(523) .
(524)
(525) .7
(526)
(527) !
(528)
(529) 9
(530)
(531)
(532) %
(533) %
(534) 5
(535) `
(536) -Q(L' -
(537)
(538) !
(539)
(540)
(541)
(542) %
(543) 0
(544) !!
(545)
(546)
(547) !
(548)
(549) 9
(550)
(551)
(552) #
(553)
(554) '
(555) L
(556) %
(557) ejection time (ET) was measured from the beginning of the left %
(558) /0
(559)
(560)
(561) !'
(562) L
(563)
(564) %
(565) %
(566)
(567)
(568) -QRL
(569)
(570)
(571)
(572) #0
(573)
(574) !
(575)
(576)
(577)
(578) /0
(579) !
(580)
(581) #
(582)
(583)
(584)
(585) %
(586) /0'
(587) L
(588) $!
(589)
(590) !5
(591)
(592)
(593)
(594) %
(595) <-
(596) 0
(597) calculated according to the formula: !"#$ !%# &'#
(598) B ' 7
(599)
(600) %
(601) !
(602) !
(603) L8-
(604)
(605) 0
(606) ! !
(607) #$
(608)
(609)
(610) %
(611)
(612)
(613)
(614)
(615) %
(616) !
(617) $ '
(618) L
(619) !
(620) 5
(621) 0
(622) %!
(623) #$
(624)
(625)
(626)
(627) # !!
(628)
(629)
(630)
(631) ! '
(632) L0
(633)
(634) !
(635) # !!
(636)
(637)
(638)
(639) %!
(640)
(641) !
(642) ! '
(643)
(644) Aortic Distensibility and Stiffness Calculations ( ) * ) measured by a single operator in at least three consecutive + #)
(645) ( )
(646) , - . ( ) ( ) + #) ( ( 01- 02 0' 3 4567+ Aortic distensibility: [(Ds8d.8d .!. Aortic stiffness index: > sd. 8s8d.8d]. Elastic modulus: !. 8s8d.8d 5 @@. Where Ds is aortic diameter at systole, Dd is aortic diameter
(647) !
(648) !
(649)
(650) $ !
(651) .
(652)
(653) >
(654)
(655) logarithm base n, Ps is systolic blood pressure, and Pd is diastolic blood pressure.. Statistical analysis SPSS software (Statistical Package for Social Sciences, %
(656) @'@
(657) 0
(658) !
(659)
(660) $
(661)
(662)
(663)
(664) $ '
(665) L
(666)
(667) % #
(668) 0
(669) 5 . !
(670)
(671)
(672) }
(673) !!
(674) !%
(675) 98
(676) !
(677)
(678)
(679) % #
(680) 0
(681) 5 . !
(682)
(683) the form of percentages. To test the normality of the distribution,
(684) S%9 %
(685)
(686) 0
(687) !'
(688) R
(689)
(690)
(691)
(692) 9!
(693)
(694) 0
(695) !
(696)
(697)
(698) % #
(699) !
(700)
(701) R . W
(702)
(703)
(704)
(705) % # '
(706) ^
(707)
(708)
(709) 0
(710) !
(711)
(712) )
(713) '
(714) Q
(715)
(716) p ~
(717) @'@
(718) 0
(719) !!
(720)
(721) #
(722) $
(723) '. 902. Results Clinical characteristics of the study population Table 1 shows general characteristics and risk factors of the study population for coronary artery disease. The two groups 0
(724)
(725) 0
(726) !
(727)
(728)
(729) ?<-
(730)
(731)
(732) $
(733) #!
(734) .
(735) !
(736) ?
(737) !
(738)
(739) !
(740) %
(741) !
(742)
(743) !
(744)
(745)
(746) % '
(747) -
(748)
(749)
(750)
(751) % $
(752) R %
(753)
(754) R(
(755) %
(756) 0
(757)
(758) 'N@}&'@+
(759) % '
(760) &'*} 'B `
(761)
(762) @'@@6
(763)
(764) !
(765)
(766) '. Analysis of the echocardiographic measurements The PE group and the controls were similar with regard to
(767)
(768) %
(769) 4
(770)
(771) _
(772)
(773)
(774)
(775) !
(776) >78
(777) !
(778) >Q<-
(779) L#
(780) &'. 2 . 1
(781)
(782) )
(783) ) . L
(784) 0
(785)
(786) 0
(787)
(788) 0
(789) !
(790)
(791)
(792) 0%
(793)
(794) 70%
(795)
(796) 0%
(797) 8L
(798)
(799) -Q(L
(800) !
(801)
(802) .7
(803)
(804) L#
(805) --'
(806) 7
(807)
(808)
(809) .
(810) 8
(811) !
(812) $
(813) the two groups were similar as far as the standard Doppler
(814) 0
(815) !'
(816) > )0
(817)
(818) !
(819) 0
(820) !
(821) between the groups in systolic (Sm), early (Am), and late (Em) !
(822) 0%
(823)
(824)
(825)
(826) .7
(827)
(828) -Q(L
(829) !
(830) -QRL
(831)
(832) 0
(833)
(834)
(835)
(836) $!
(837)
(838) !5
(839) <-
(840) !
(841) .^
(842) L#
(843) --'. Analysis of the aortic parameters The two groups were similar with regard to systolic and !
(844)
(845) !
(846) &'6B}@'*&
(847) % '
(848) &'N@}@'&`
(849) &' }@'*
(850) %
(851) &'&}@'*&'
(852) P@'@'
(853)
(854)
(855) 0
(856) )!
(857) #$
(858) 0
(859)
(860)
(861) &'&*}B'&&
(862) % '
(863) &&'} 'BB`
(864) @'@@
(865) !
(866) 78
(867) +' }*'BB
(868) % '
(869) ' 6}B'+N`
(870) @'@ N'
(871) !
(872)
(873) 79-
(874) 6'&}+'NB
(875) % '
(876) '@B}&'* '
(877) @'@@
(878) !
(879) 7<
(880) 6'@@}+'N
(881) % '
(882) &'NB}&' '
(883) @'@@
(884)
(885) !
(886)
(887)
(888) L#
(889) '. #) )
(890) 8 ) "% ) * 8. L
(891) 0
(892)
(893) %
(894)
(895) #0
(896) R(
(897)
(898)
(899)
(900) !
(901) !
(902)
(903)
(904)
(905) @'* N`
(906) @'@@6
(907)
(908) ! # $
(909) @'**+`
(910) @'@@*
(911) !
(912) 9
(913) @' &`
(914) @'@@
(915)
(916)
(917)
(918) !
(919)
(920) %
(921)
(922) #0
(923) R(
(924)
(925)
(926)
(927) !
(928) !
(929)
(930) .
(931) !5
(932) @'B+`
(933) @'@ &
(934)
(935)
(936) !
(937) @'+`
(938) @'@&
(939) !
(940)
(941) 5
(942) -Q(L
(943) @'*@`
(944) @'@&
(945) on the other (Table 4).. %
(946) 8 ( ) )
(947) ) . _
(948)
(949)
(950)
(951) # %
(952) !
(953) # %
(954) .
(955)
(956) 0
(957) !
(958)
(959) #
(960) @'NB
(961) ~@'@@
(962) !
(963) P@'B &
(964) ~@'@@
(965) %$'. Discussion L
(966)
(967) #
(968)
(969)
(970) )0!
(971)
(972) !$
(973)
(974) #
(975)
(976)
(977)
(978)
(979) %
(980)
(981)
(982)
(983) !
(984)
(985) $
(986) and unaffected myocardial performance index in patients with !
(987) '
(988) <%
(989)
(990)
(991) !
(992)
(993)
(994) #
(995) $
(996) !
(997) 0
(998) / ' !
(999) !
(1000) %
(1001) $
(1002) 0
(1003)
(1004) )
(1005) #0
(1006)
(1007) !
(1008) !
(1009) )
(1010)
(1011) ! %
(1012) !
(1013)
(1014)
(1015) $
(1016) +
(1017)
(1018) & '
(1019) ? !
(1020)
(1021) )
(1022)
(1023) !
(1024)
(1025) ! %
(1026)
(1027) 0
(1028) !
(1029)
(1030) #
(1031) N &
(1032)
(1033)
(1034)
(1035) 0
(1036) 0
(1037)
(1038) !
(1039)
(1040) ! %$
(1041)
(1042) !
(1043)
(1044) %
(1045) peers [6]. -
(1046) !
(1047) #
(1048) !
(1049)
(1050)
(1051)
(1052)
(1053)
(1054)
(1055) mortality and morbidity in such cases is ischemic heart disease. © Polskie Towarzystwo Ginekologiczne. Nr 12/2014.
(1056) Ginekol Pol. 2014, 85, 900-907. P R A C E. O R Y G I N A L N E g i n e kol og i a. Faika Ceylan Ciftci et al. Does mild preeclampsia cause arterial stiffness and ventricular remodeling through inflammation?. Table I. Demographic and baseline biochemical measurements of patient and control groups. Preeclampsia (n=40). Control (n=27). p. 33.75±7.95. 36.44±10.45. 0.262. Total cholesterol (mg/dl). 187.55±32.48. 182.77±30.77. 0.545. HDL cholesterol (mg/dl). 47.20±8.42. 49.96±11.02. 0.276. LDL cholesterol (mg/dl). 115.77±25.49. 108.03±22.35. 0.194. Triglyceride (mg/dl). 113.50±52.71. 125.29±62.44. 0.424. Age (year). hsCRP(mg/L). 3.80±2.06. 2.43±1.91. 0.007. Creatinin(mg/dl). 0.79±0.12. 0.78±0.08. 0.591. Fasting Glucose(mg/dl). 93.27±6.89. 95.18±7.40. 0.292. ALT. 21.20±11.84. 20.25±7.92. 0.698. Uric acid(mg/dl). 4.01±.77±. 3.65±.87. 0.099. Hemoglobin (g/dL). 13.59±3.81. 13.39±1.27. 0.762. A bbre v i a t io ns: HDL – high density lipoprotein cholesterol. LDL – low density lipoprotein cholesterol. hsCRP – high sensitive C-reactive protein. ALT – Serum Alanine Amino Transferase. Data was presented as mean ± standard deviation.. Table II. Left ventricular systolic and diastolic function measurements.. Emax (cm/s). Preeclampsia. Control. p. 83.52± 17.83. 82.22± 16.09. 0.757. Amax (cm/s). 70.45± 19.43. 63.55± 11.89. 0.077. E DT (ms). 209.20± 32.53. 223.43± 41.39. 0.219. Mitral IVRT(ms). 91.30± 15.34. 88.41± 15.26. 0.488. Emax/Amax ratio. 1.23± 0.29. 1.32± .28. 0.213. Sm (cm/s). 14.31± 2.71. 14.44± 2.93. 0.853. Em (cm/s). 20.35± 3.97. 18.70± 4.67. 0.138. Am (cm/s). 15.83± 3.31. 15.37± 3.31. 0.579. Em/Am ratio IVRT (ms). 1.32± 0.30. 1.28± .47. 0.741. 98.19± 26.71. 104.40± 38.16. 0.468. IVCT (ms). 53. 73± 12.06. 49.51± 11.46. 0.153. ET (ms). 282.74± 36.55. 299.88± 44.43. 0.103. MPI. 0.55± 0.16. EF. 69.02± 4.59. 67.03± 5.57. 0.53± 0.19. 0.630 0.133. E/e’. 4.22±1.23. 4.61±1.27. 0.214. A bbre v i a t io ns: Sm – systolic peak velocity; Em – early peak velocity; Am – atrial peak velocity; IVRT – isovolumic relaxation time; IVCT – isovolumic contraction time; ET – ejection time; MPI: myocardial performance index; EF – left ventricular ejection fraction.; EDT – Mitral Emax wave deceleration time. E/e’ – ratio of the mitral velocity to the early-diastolic velocity of the mitral annulus. Data was presented as mean ± standard deviation..
(1057)
(1058)
(1059)
(1060) '
(1061) -
(1062)
(1063) 0
(1064) %
(1065)
(1066)
(1067)
(1068) !
(1069)
(1070) .
(1071)
(1072)
(1073) 0
(1074) $
(1075) #
(1076) !
(1077) !
(1078) %
(1079)
(1080) after preeclamptic pregnancies. The magnitude of this increase tends to be greater in more serious cases of preeclampsia, as 0
(1081)
(1082)
(1083) $
(1084) '
(1085) _
(1086)
(1087)
(1088)
(1089)
(1090) be suggested that arterial stiffness contributes to the increased )
(1091)
(1092) ! %
(1093)
(1094) !%
(1095)
(1096) 0
(1097) with a history of preeclampsia. Furthermore, arterial stiffness
(1098) %
(1099) #
(1100) %
(1101)
(1102) #
(1103)
(1104)
(1105)
(1106) !
(1107) the onset of preeclampsia [14]. According to recent reports,. Nr 12/2014. endothelial dysfunction might stem from abnormal placentation, insofar as the latter can cause placental ischemia and stimulate the
(1108)
(1109)
(1110) !
(1111) !
(1112)
(1113)
(1114)
(1115) %
(1116) endothelium [15, 16]. A study by Chambers et al., showed that impaired endothelial function in women with preeclampsia was not linked to maternal obesity, hypertension, metabolic disturbances associated with
(1117) .
(1118) !$ !
(1119)
Benzer Belgeler
We evaluated the anthropometrics indicators in Latvian women in the age over 40 years, various somatometric measurements – height (cm), the body mass (kg), the circumference of
No significant difference was found between the patient group with acromegaly and the healthy control group in terms of peripheral systolic blood pressure, peripheral main arterial
Example: Standard forms are used by both genders but women tend to use it more than men and by definition men use more vernacular forms than women do.. Gender-specific
Factors affecting left ventricular synchronicity in hypertensive patients: are arterial stiffness and central blood pressures influential?. Hipertansiyonlu hastalarda sol
Material and Methods: Measurements of umbilical artery PI, RI, S/D, middle cerebral artery (MCA) PSV, PI, RI and mean PI, RI S/D of uterine arteries assessed 1 hour before OGTT and
While the men belonging to a patriarchal society (Thornton and his two brothers) prove to be more resistant to adapting to the Western culture, women’s understanding of femininity
Bulgular: Araştırmada 36-50 yaş grubunda olan, çalışan, 1-3 arası gebelik ve çocuk sayısı olan, oral kontraseptif kullanan ve jinekolojik kanserlerin önlenip
Kadınların profesyonel aile planlaması danışmanlığı alma durumuna göre yöntem seçimleri arasında anlamlı ilişki olduğu, buna göre aile planlaması
