Ultrasound study of carotid and cardiac remodeling and cardiac-arterial coupling in normal pregnancy and preeclampsia: a case control study.
Ultrasound study of carotid and cardiac remodeling and cardiac-arterial coupling in normal pregnancy and preeclampsia: a case control study.
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正常妊娠和先兆子痫中颈动脉和心脏重塑以及心脏动脉耦合的超声研究：病例对照研究。
DOI：
10.1186/1471-2393-14-113
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发表时间：
2014-03-25
影响因子：
3.1
通讯作者：
Zhou N
中科院分区：
文献类型：
--
作者：
Yuan LJ;Duan YY;Xue D;Cao TS;Zhou N
心血管适应，如心脏和子宫螺旋动脉重塑，主动脉硬化在怀孕期间已被广泛研究，而弹性动脉和左心室之间的相互作用知之甚少。本研究旨在应用超声技术评价正常妊娠和子痫前期患者的心-动脉耦联。23名入院前未接受降压治疗的先兆子痫妇女和40名年龄（27.2 ± 3.0岁vs. 29.1 ± 5.7岁，p = 0.0805）和孕周（35.6 ± 3.4 wk vs. 34.8 ± 3.6 wk，p = 0.3573）匹配的血压正常孕妇被纳入研究。所有女性都签署了知情同意书。所有患者均为初产妇，均为单胎妊娠，且无其他动脉硬化的危险因素。使用MylabTwice超声装置（Esaote，意大利）进行颈动脉和心脏超声检查。分析心脏和颈动脉重塑及其相关性。左室-颈动脉耦联以动脉弹性（Ea）与左室收缩弹性（Ees）的比值为特征。产后16-20个月进行随访。左心室和颈动脉重构在先兆子痫妇女中比正常妊娠对照组更常见（96% vs. 40%，82% vs. 48%，均p < 0.0001）。两组颈动脉壁相对厚度无显著性差异。然而，颈动脉横截面积，颈动脉质量的替代品，在先兆子痫中显著大于正常对照组（11.23 ± 0.17 mm 2 vs. 8.58 ± 1.88 mm 2，p < 0.00001）。颈动脉僵硬度和内膜中层厚度与心脏舒张功能参数和血压显著相关（p < 0.05）。先兆子痫患者的Ea和Ees均显著高于正常妊娠对照组（Ea：2.41 ± 0.57 mmHg/ml vs. 1.98 ± 0.46 mmHg/ml，p = 0.0005; Ees：11.68 ± 9.51 m/s2 vs. 6.91 ± 6.13 m/s2，p = 0.002）。然而，两组之间的左心室-颈动脉耦联指数Ea/Ees无显著差异。颈动脉重塑持续在先兆子痫妇女和正常妊娠对照组产后16-20个月。在先兆子痫和正常妊娠中均观察到显著的心脏和颈动脉重塑以及相似的左心室-颈动脉偶联。产后颈动脉重塑可能持续存在。需要更大人群的进一步研究来证实这些发现。
Cardiovascular adaptions, such as cardiac and uterine spiral arterial remodeling, and aortic arterial stiffening during pregnancy have been extensively investigated, while the interactions between the elastic artery and the left ventricle are poorly understood. This study was to evaluate the cardiac-arterial coupling in both normal pregnancy and preeclampsia using ultrasound techniques. Twenty-three preeclamptic women with no antihypertensive treatment prior to admission, and 40 age- (27.2 ± 3.0 y vs. 29.1 ± 5.7 y, p = 0.0805) and gestational week- (35.6 ± 3.4 wk vs. 34.8 ± 3.6 wk, p = 0.3573) matched normotensive pregnant women were included. All women signed informed consent. All were nulliparas, had singleton pregnancies, and had no other risk factors for arterial stiffening. Carotid and cardiac ultrasound was performed using a MylabTwice ultrasound unit (Esaote, Italy). Cardiac and carotid remodeling and their associations were analyzed. Left ventriculo-carotid coupling was characterized by the ratio between the arterial elastance (Ea) and the left ventricular systolic elastance (Ees). Follow-up study was performed 16–20 months after parturition. Left ventricular and carotid arterial remodeling was seen more frequently in preeclamptic women than in normal pregnant controls (96% vs. 40%, 82% vs. 48%, both p < 0.0001). The relative carotid arterial wall thickness showed no significant difference between the two groups. However, the carotid cross-sectional area, a surrogate for carotid arterial mass, was significantly greater in preeclampsia than that in normal controls (11.23 ± 0.17 mm2 vs. 8.58 ± 1.88 mm2, p < 0.00001). Carotid arterial stiffness and intima-media thickness correlated significantly with cardiac diastolic function parameters and blood pressures (p < 0.05). Both Ea and Ees were significantly greater in preeclampsia, compared with values in normal pregnant controls (Ea: 2.41 ± 0.57 mmHg/ml vs. 1.98 ± 0.46 mmHg/ml, p = 0.0005; Ees: 11.68 ± 9.51 m/s2 vs. 6.91 ± 6.13 m/s2, p = 0.002). However, there was no significant difference in the left ventriculo-carotid coupling index, Ea/Ees, between the two groups. Carotid remodeling persisted in both preeclamptic women and normal pregnant controls 16–20 months after parturition. Significant cardiac and carotid remodeling and similar left ventriculo-carotid coupling were observed in both preeclampsia and normal pregnancy. Carotid remodeling may persist postpartum. Further studies with larger populations are needed to confirm these findings.
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影响因子：
8.3
作者：
Macedo, Maria L.;Luminoso, Daniele;Nicolaides, Kypros H.
通讯作者：
Nicolaides, Kypros H.
影响因子：
8.3
作者：
Blacher, J;Asmar, R;Safar, ME
通讯作者：
Safar, ME
影响因子：
5.4
作者：
Shantsila, Alena;Dwivedi, Girish;Lip, Gregory Y. H.
通讯作者：
Lip, Gregory Y. H.
影响因子：
37.8
作者：
Blacher, J;Guerin, AP;London, GM
通讯作者：
London, GM
影响因子：
2.8
作者：
TEICHHOLZ, LE;KREULEN, T;GORLIN, R
通讯作者：
GORLIN, R