Pregnancy induces persistent changes in vascular compliance in primiparous women.
Pregnancy induces persistent changes in vascular compliance in primiparous women.
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DOI：
10.1016/j.ajog.2015.01.005
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发表时间：
2015-05
影响因子：
9.8
通讯作者：
Bernstein, Ira M.
中科院分区：
文献类型：
--
作者：
Morris, Erin A.;Hale, Sarah A.;Badger, Gary J.;Magness, Ronald R.;Bernstein, Ira M.
妊娠导致心血管系统发生快速、渐进和实质性的变化。尽管有家族易感性，但子痫前期的复发风险较低，这表明与妊娠相关的适应性降低了随后子痫前期的风险。我们的目的是评估妊娠对母体心血管生理的持续影响。45名健康的未生育妇女在孕前接受基线心血管评估，并在平均30个月后重复。基线评估后，17名妇女（妊娠）为单胎妊娠，全部足月分娩。其余28名妇女为未怀孕对照组（NP）。我们在每次就诊时测量平均动脉血压（MAP）、心输出量（CO）、血浆容量（PV）、脉搏波速度（PWV）、子宫血流量（UBF）和血流介导的血管舒张（FMD）。间隔妊娠妇女孕前至产后平均动脉压显著降低（孕前：85.3±1.8 mm Hg，产后：80.5±1.8 mm Hg）， NP组无变化（就诊1:8 0.3±1.4 mm Hg，就诊2:8 2.8±1.4 mm Hg）， （p = 0.002）。间隔妊娠妇女（孕前：2.73±0.05，产后：2.49±0.05 m/s）与未间隔妊娠妇女（第1次就诊：2.56±0.04，第2次就诊：2.50±0.04 m/s）相比，脉搏波速度显著降低（p = 0.005）。我们没有观察到妊娠对心输出量、血浆量、子宫血流量或血流介导的血管舒张的残余影响。我们观察到怀孕后平均动脉压降低和动脉硬度降低，这表明怀孕对母体心血管重塑有显著的有利影响。这些发现可能代表了一种机制，通过这种机制，子痫前期的风险在随后的怀孕中降低。
Pregnancy induces rapid, progressive and substantial changes to the cardiovascular system. The low recurrence risk of preeclampsia, despite familial predisposition, suggests an adaptation associated with pregnancy that attenuates risk for subsequent preeclampsia. We aimed to evaluate the persistent effect of pregnancy on maternal cardiovascular physiology. Forty-five healthy nulliparous women underwent baseline cardiovascular assessment preconception and repeated an average of 30 months later. After baseline evaluation, 17 women (Preg) conceived singleton pregnancies and all delivered at term. The remaining 28 women comprised the non-pregnant control group (NP). We measured mean arterial blood pressure (MAP), cardiac output (CO), plasma volume (PV), pulse wave velocity (PWV), uterine blood flow (UBF), and flow-mediated vasodilation (FMD) at each visit. There was a significant decrease in mean arterial pressure from the prepregnancy visit to postpartum in women with an interval pregnancy (prepregnancy: 85.3±1.8, postpartum: 80.5±1.8 mm Hg), with no change in NP subjects (visit 1: 80.3±1.4, visit 2: 82.8±1.4 mm Hg), (p = .002). Pulse wave velocity was significantly decreased in women with an interval pregnancy (prepregnancy: 2.73±0.05, postpartum: 2.49±0.05 m/s), as compared to those without an interval pregnancy (visit 1: 2.56±0.04, visit 2: 2.50±0.04 m/s), (p = .005). We did not observe a residual effect of pregnancy on cardiac output, plasma volume, uterine blood flow or flow-mediated vasodilation. Our observations of decreased mean arterial pressure and reduced arterial stiffness following pregnancy suggest a significant favorable effect of pregnancy on maternal cardiovascular remodeling. These findings may represent a mechanism by which preeclampsia risk is reduced in subsequent pregnancies.
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DOI：
10.1136/heartjnl-2013-304739
发表时间：
2013-12
期刊：
Heart (British Cardiac Society)
影响因子：
--
作者：
Maruhashi T;Soga J;Fujimura N;Idei N;Mikami S;Iwamoto Y;Kajikawa M;Matsumoto T;Hidaka T;Kihara Y;Chayama K;Noma K;Nakashima A;Goto C;Tomiyama H;Takase B;Yamashina A;Higashi Y
通讯作者：
Higashi Y
影响因子：
7.2
作者：
Bernstein, IM;Ziegler, WF;Badger, GJ
通讯作者：
Badger, GJ
影响因子：
5
作者：
Mikolajczyk, Rafael T.;Zhang, Jun;Grewal, Jagteshwar
通讯作者：
Grewal, Jagteshwar
影响因子：
6.2
作者：
Shachar, Bat Zion;Lyell, Deirdre J.
通讯作者：
Lyell, Deirdre J.
DOI：
10.1111/j.1471-0528.2008.01906.x
发表时间：
2009-01-01
影响因子：
5.8
作者：
Khalil, A. A.;Cooper, D. J.;Harrington, K. F.
通讯作者：
Harrington, K. F.