Placental vascular abnormalities in the mouse alter umbilical artery wave reflections
Placental vascular abnormalities in the mouse alter umbilical artery wave reflections
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DOI：
10.1152/ajpheart.00733.2018
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发表时间：
2019-03-01
影响因子：
4.8
通讯作者：
Sled, John G.
中科院分区：
文献类型：
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作者：
Cahill, Lindsay S.;Zhou, Yu-Qing;Sled, John G.
目前检测胎盘血管病变的方法监测脐动脉(UA)搏动性的多普勒超声变化，仅有中等诊断价值，特别是在妊娠晚期。在胎鼠身上，我们最近证明了反射的压力波在UA中的传播方向与血流方向相反，并建议测量这些反射作为检测胎盘循环异常的一种手段。在本研究中。我们使用这种方法结合微型计算机断层扫描来研究胎盘血管结构改变和UA波反射指标改变之间的关系。对对照组C57BL6/J小鼠和接受联合抗逆转录病毒治疗(CART)的母鼠在胚胎15.5天和E17.5天的胎儿进行了评估，CART是一种已知的胎儿生长受限模型。而反射系数在E15.5时组间无差异，在E17.5时CART处理组小鼠的反射系数比对照组高27%。反射系数的增加对应于血管节段总数增加36%，这是衡量整体结构复杂性的一个指标。有趣的是，两组间UA搏动指数无差异。这表明波反射传递了常规超声测量无法捕捉到的关于血管结构的信息。波形反射参数与胎儿胎盘动脉树的形态有关，UA与第一分支点的面积比与反射系数相关。这项研究突出了波反射在胎盘血管病理的非侵入性临床评估中的潜力。新与值得注意的是，我们使用了一种新的超声方法，基于检测沿脐动脉传播的脉冲压力波，来研究波反射指标的变化与微计算机断层扫描显示的胎盘血管结构改变之间的关系。使用联合抗逆转录病毒治疗的怀孕小鼠，一个胎儿生长受限的模型，我们证明了脐动脉的反射对胎盘血管异常敏感，并与胎儿胎盘树的几何形状有关。
Current methods to detect placental vascular pathologies that monitor Doppler ultrasound changes in umbilical artery (UA) pulsatility have only moderate diagnostic utility, particularly in late gestation. In fetal mice, we recently demonstrated that reflected pressure waves propagate counter to the direction of flow in the UA and proposed the measurement of these reflections as a means to detect abnormalities in the placental circulation. In the present study. we used this approach in combination with microcomputed tomography to investigate the relationship between altered placental vascular architecture and changes in UA wave reflection metrics. Fetuses were assessed at embryonic day (E)15.5 and E17.5 in control C57BL6/J mice and dams treated with combination antiretroviral therapy (cART), a known model of fetal growth restriction. Whereas the reflection coefficient was not different between groups at E15.5, it was 27% higher at E17.5 in cART-treated mice compared with control mice. This increase in reflection coefficient corresponded to a 36% increase in the total number of vessel segments, a measure of overall architectural complexity. Interestingly, there was no difference in UA pulsatility index between groups. suggesting that the wave reflections convey information about vascular architecture that is not captured by conventional ultrasound metrics. The wave reflection parameters were found to be associated with the morphology of the fetoplacental arterial tree, with the area ratio between the UA and first branch points correlating with the reflection coefficient. This study highlights the potential for wave reflection to aid in the noninvasive clinical assessment of placental vascular pathology.NEW & NOTEWORTHY We used a novel ultrasound methodology based on detecting pulse pressure waves that propagate along the umbilical artery to investigate the relationship between changes in wave reflection metrics and altered placental vascular architecture visualized by microcomputed tomography. Using pregnant mice treated with combination antiretroviral therapy, a model of fetal growth restriction, we demonstrated that reflections in the umbilical artery are sensitive to placental vascular abnormalities and associated with the geometry of the fetoplacental tree.