Abstract 15062: Aortic Stiffness and ProBNP Are Increased at Term and 6 Months After Pre-Eclamptic Pregnancy
Introduction: Pre-eclampsia (PE) is defined by hypertension and proteinuria and occurs in 3–10% of all pregnancies. The hemodynamic patophysiology of the heart and systemic arteries in these patients have not been well described. Thus, we compared systemic arterial properties to cardiac hormonal status (proBNP) at term and 6 months post-partum in women with PE and in women with normal pregnancy (NP).
Methods: 40 women (32 ± 6 years) with PE and 65 (33 ± 1 years) with NP were studied. Noninvasive estimates of aortic root flow pressure and pressure were obtained by Doppler and calibrated right subclavian artery pulse trace. Total arterial compliance (C), arterial elastance (end systolic pressure/ stroke volume, Ea), characteristic impedance (Z0), and peripheral arterial resistance (R) were estimated both by use of a 4-element Windkessel model (WK) and by Fourier analysis of pressure and flow data. ProBNP was determined by an electrochemiluminescence immunoassay on a modular platform (Roche Diagnostics, Basel, Switzerland).
Results: (Table) At term, in PE pregnancy, Z0, Ea and R were higher and C was lower than in NP, indicating a higher resistance in the entire systemic arterial tree. Furthermore, Z0, Ea and R were maintained elevated at 6 months follow-up in PE underscoring the chronic nature of this disease. Also, in PE pregnancy proBNP was almost three-fold increased at term compared with 6 months follow-up. ProBNP in PE pregnancy at term correlated with the systemic arterial resistance parameters R (r = − 0.442, p = 0.007) and Ea (r = −0.515, p = 0.001).
Conclusion: PE is characterized by an increased systemic arterial proximal and peripheral resistance at term and 6 months post partum, with significantly elevated proBNP levels, also when compared to NP. These results indicate that the pathophysiological cardiovascular disturbances in PE prevail after pregnancy.
- © 2010 by American Heart Association, Inc.