- Email: [email protected]
[56-OR]
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Abstracts / Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 5 (2015) 2–52
nitude of change is similar to that of anti-angiogenic factors (7.3-fold). The objective was to determine whether: (1) patients with PE have a different profile of plasma sST2concentrations than those with uncomplicated pregnancies; and (2) the changes in sST2 occur prior to the diagnosis of PE. Methods: A longitudinal nested case-control study included singleton pregnancies in the following groups: (1) uncomplicated pregnancies (n = 160; 1101 samples); and (2) patients who subsequently developed PE (cases, n = 40; 227 samples). Cases were early (delivered <34 weeks, n = 9) and late PE (n = 31). Maternal plasma sST2 concentrations were determined by ELISA. Analysis used mixedeffects models. Results: (1) Patients who subsequently developed PE had a different profile (concentration changes over time) of plasma sST2 concentrations than normal pregnancies (p < 0.0001); (2) Plasma sST2 concentration in early and late PE was significantly higher than uncomplicated pregnancies from 22 to 33 weeks of gestation, respectively (both p < 0.05) and (3) these changes started approximately 6 weeks prior to clinical diagnosis. Conclusions: Maternal plasma sST2 concentrations are elevated six weeks prior to clinical diagnosis of PE. An increase in maternal plasma concentration of sST2 may contribute to exaggerated intravascular inflammatory response, and/or, the Th1/Th2 imbalance. Figure legend: Maternal plasma concentrations of sST2 in uncomplicated pregnancies (black) and PE (red). The vertical lines on the PE curve denote significant differences between the two groups. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)
[55-OR] 17-hydroxyprogesterone caproate attenuates hypertension and uterine artery resistance in response to Reduced Uterine Perfusion Pressure (RUPP) in pregnant rats Lorena M. Amaral, Denise C. Cornelius, Janae Moseley, James N. Martin, Babbette LaMarca (University of Mississippi Medical Center, Jackson, MS, USA) Objectives: Preeclampsia (PE), new onset hypertension at 20 weeks of gestation, is characterized by increased uterine artery resistance index (UARI), chronic immune activation and decreased of vasodilators such as nitric oxide (NO). 17-alpha-hydroxyprogesterone caproate (17-OHPC) is a synthetic metabolite of progesterone used for the prevention of recurrent preterm birth. The objective of this study was to determine whether 17-OHPC could reduce blood pressure (MAP), inflammation, UARI, as well as increase NO bioavailability in a hypertensive rat model of PE. Methods: 17-OHPC (3.32 mg/kg) was intraperitoneally administered on day 18 of gestation into Reduced Uterine Perfusion Pressure (RUPP) rats and carotid catheters were inserted. MAP, blood and tissues were collected on day 19. Results: MAP in NP rats (n = 13) was 92 ± 2; 123 ± 2 in RUPP (n = 18), and 116 ± 1 mmHg in RUPP + 17-OHPC (n = 10). UARI was 0.78 ± 0.03 in RUPP (n = 4) and 0.63 ± 0.038 in RUPP + 17-OHPC (n = 8). Circulating CD4+ T cells were 1.19 ± 1.0% of gated cells in NP (n = 7), which increased to 8.52 ± 2.4% in RUPP rats (n = 10) but was significantly reduced to 2.72 ± 0.87% (n = 14) in RUPP + 17-OHPC. Circulating nitrate/nitrite was 26.34 ± 3.5 lM in NP (n = 12); 14.58 ± 3.1 in RUPP rats (n = 8) and increased to 26.69 ± 1.62 in RUPP + 17-OHPC (n = 7. eNOS expression was 0.65 ± 0.11 A.U in NP (n = 4), which decreased to 0.33 ± 0.01 in RUPP rats (n = 4) but increased to 0.57 ± 0.01 in RUPP+17-OHPC (n = 5). Levels of TNF-alpha were 65.84 ± 17.7 pg/ml in RUPP rats (n = 5) but were blunted to 17.24 ± 3.9 in RUPP + 17OHPC (n = 8). Conclusions: In conclusion, 17-OHPC improves inflammation, UARI, hypertension, and NO bioavailability in response to placental ischemia during pregnancy. Disclosures: L.M. Amaral: None. D.C. Cornelius: None. J. Moseley: None. J.N. Martin: None. B. LaMarca: None. doi:10.1016/j.preghy.2014.10.059
[56-OR]
Disclosures: P. Chaemsaithong: None. R. Romero: None. A.L. Tarca: None. Z. Xu: None. A.I. Ahmed: None. S.S. Hassan: None. L. Yeo: None. T. Chaiworapongsa: None. doi:10.1016/j.preghy.2014.10.058
Placental lesions of vascular insufficiency are associated with anti-angiogenic state in women with preeclampsia Kedak Baltajian a, Jonathan L. Hecht a, Julia B. Wenger b, Saira Salahuddin a, Stefan Verlohren c, Frank H. Perschel c, Zsuzsanna K. Zsengeller a, Ravi Thadhani b, S. Ananth Karumanchi a, Sarosh Rana a (a Beth Israel Deaconess Medical Center, Boston, MA, USA, b Massachusetts General Hospital, Boston, MA, USA, c Charité University Medicine, Berlin, Germany)
Abstracts / Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 5 (2015) 2–52
Objectives: To evaluate if placental histopathological changes of vascular insufficiency correlate with circulating angiogenic factors in patients with preeclampsia. Methods: Subjects were selected from a previous prospective cohort study of preeclampsia based on availability of plasma anti-angiogenic factor (sFlt1) and pro-angiogenic factor (PlGF) measurements and placental histology specimens. Preeclamptic patients were divided into two groups based on plasma levels of these factors described as a ratio; anti-angiogenic preeclampsia with sFlt1/PlGF ratio P85 and normal angiogenic preeclampsia with sFlt1/PlGF <85. The placental lesions of vascular insufficiency that were studied specifically included: atherosis, infarcts, syncytial knots, acute and chronic abruption, hematoma and fetal thrombosis. The data is shown as median (quartile1, quartile3) or n (%) when appropriate. Results: The anti-angiogenic preeclampsia group (N = 48) presented at an earlier gestational age (weeks) than the normal angiogenic group (N = 28); {32 (28, 34) vs. 35 (32, 36), P = 0.002}, had higher systolic blood pressure (mmHg) {154 (147, 168) vs. 147 (132, 158), P = 0.02}, delivered early (weeks) {(32 (29, 34) vs. 36 (34, 37), P < 0.001} and had lower birth weight (g) {(1,550 (1.055, 2.060) vs. 2.655 (2.285, 3.343), P < 0.001}. Several pathologic lesions were found significantly more often in the anti-angiogenic preeclampsia group; atherosis {27.7 % vs. 3.6%, P < 0.05}, infarcts {58.3% vs. 3.6%, P = 0.002} and syncytial knots {81.3% vs. 39.3%, P < 0.001}. Conclusions: Preeclamptic patients with imbalance in circulating angiogenic factors have disproportionally higher rates of placental vascular lesions historically associated with severe disease.
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Disclosures: K. Baltajian: None. J.L. Hecht: None. J.B. Wenger: None. S. Salahuddin: None. S.S. Verlohren: Consultant, Research Support Recipient, Commercial Interest: Roche Diagnostics, ThermoFisher, Novartis. F.H. Perschel: None. Z.K. Zsengeller: None. R. Thadhani: named as coinventors of patents related to use of angiogenic biomarkers in preeclampsia that are held by Harvard Hospitals, has financial interest in Aggamin LLC. S. Karumanchi: named as co-inventors of patents related to use of angiogenic biomarkers in preeclampsia that are held by Harvard Hospitals, S.A.K has financial interest in Aggamin LLC, Consultant to Siemens, and Roche diagnostics.. S. Rana: None. doi:10.1016/j.preghy.2014.10.060
[57-OR] Clonidine versus captopril for severe postpartum hypertension: A randomized controlled trial Leila Katz, Carlos Noronha Neto, Sabina Maia, Isabela Coutinho, Alex Sr Souza, Melania Mr Amorim (IMIP, Recife, Brazil) Objectives: To evaluate the effectiveness and safety of clonidine compared to captopril for treating severe postpartum hypertension. Methods: A randomized, drug-controlled, triple-blind clinical trial evaluating 90 postpartum women receiving captopril or clonidine. Inclusion criteria consisted of: women with hypertensive disorders of pregnancy [systolic blood pressure (SBP) equal or above 180 mmHg and/or
Abstracts / Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 5 (2015) 2–52
nitude of change is similar to that of anti-angiogenic factors (7.3-fold). The objective was to determine whether: (1) patients with PE have a different profile of plasma sST2concentrations than those with uncomplicated pregnancies; and (2) the changes in sST2 occur prior to the diagnosis of PE. Methods: A longitudinal nested case-control study included singleton pregnancies in the following groups: (1) uncomplicated pregnancies (n = 160; 1101 samples); and (2) patients who subsequently developed PE (cases, n = 40; 227 samples). Cases were early (delivered <34 weeks, n = 9) and late PE (n = 31). Maternal plasma sST2 concentrations were determined by ELISA. Analysis used mixedeffects models. Results: (1) Patients who subsequently developed PE had a different profile (concentration changes over time) of plasma sST2 concentrations than normal pregnancies (p < 0.0001); (2) Plasma sST2 concentration in early and late PE was significantly higher than uncomplicated pregnancies from 22 to 33 weeks of gestation, respectively (both p < 0.05) and (3) these changes started approximately 6 weeks prior to clinical diagnosis. Conclusions: Maternal plasma sST2 concentrations are elevated six weeks prior to clinical diagnosis of PE. An increase in maternal plasma concentration of sST2 may contribute to exaggerated intravascular inflammatory response, and/or, the Th1/Th2 imbalance. Figure legend: Maternal plasma concentrations of sST2 in uncomplicated pregnancies (black) and PE (red). The vertical lines on the PE curve denote significant differences between the two groups. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)
[55-OR] 17-hydroxyprogesterone caproate attenuates hypertension and uterine artery resistance in response to Reduced Uterine Perfusion Pressure (RUPP) in pregnant rats Lorena M. Amaral, Denise C. Cornelius, Janae Moseley, James N. Martin, Babbette LaMarca (University of Mississippi Medical Center, Jackson, MS, USA) Objectives: Preeclampsia (PE), new onset hypertension at 20 weeks of gestation, is characterized by increased uterine artery resistance index (UARI), chronic immune activation and decreased of vasodilators such as nitric oxide (NO). 17-alpha-hydroxyprogesterone caproate (17-OHPC) is a synthetic metabolite of progesterone used for the prevention of recurrent preterm birth. The objective of this study was to determine whether 17-OHPC could reduce blood pressure (MAP), inflammation, UARI, as well as increase NO bioavailability in a hypertensive rat model of PE. Methods: 17-OHPC (3.32 mg/kg) was intraperitoneally administered on day 18 of gestation into Reduced Uterine Perfusion Pressure (RUPP) rats and carotid catheters were inserted. MAP, blood and tissues were collected on day 19. Results: MAP in NP rats (n = 13) was 92 ± 2; 123 ± 2 in RUPP (n = 18), and 116 ± 1 mmHg in RUPP + 17-OHPC (n = 10). UARI was 0.78 ± 0.03 in RUPP (n = 4) and 0.63 ± 0.038 in RUPP + 17-OHPC (n = 8). Circulating CD4+ T cells were 1.19 ± 1.0% of gated cells in NP (n = 7), which increased to 8.52 ± 2.4% in RUPP rats (n = 10) but was significantly reduced to 2.72 ± 0.87% (n = 14) in RUPP + 17-OHPC. Circulating nitrate/nitrite was 26.34 ± 3.5 lM in NP (n = 12); 14.58 ± 3.1 in RUPP rats (n = 8) and increased to 26.69 ± 1.62 in RUPP + 17-OHPC (n = 7. eNOS expression was 0.65 ± 0.11 A.U in NP (n = 4), which decreased to 0.33 ± 0.01 in RUPP rats (n = 4) but increased to 0.57 ± 0.01 in RUPP+17-OHPC (n = 5). Levels of TNF-alpha were 65.84 ± 17.7 pg/ml in RUPP rats (n = 5) but were blunted to 17.24 ± 3.9 in RUPP + 17OHPC (n = 8). Conclusions: In conclusion, 17-OHPC improves inflammation, UARI, hypertension, and NO bioavailability in response to placental ischemia during pregnancy. Disclosures: L.M. Amaral: None. D.C. Cornelius: None. J. Moseley: None. J.N. Martin: None. B. LaMarca: None. doi:10.1016/j.preghy.2014.10.059
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Disclosures: P. Chaemsaithong: None. R. Romero: None. A.L. Tarca: None. Z. Xu: None. A.I. Ahmed: None. S.S. Hassan: None. L. Yeo: None. T. Chaiworapongsa: None. doi:10.1016/j.preghy.2014.10.058
Placental lesions of vascular insufficiency are associated with anti-angiogenic state in women with preeclampsia Kedak Baltajian a, Jonathan L. Hecht a, Julia B. Wenger b, Saira Salahuddin a, Stefan Verlohren c, Frank H. Perschel c, Zsuzsanna K. Zsengeller a, Ravi Thadhani b, S. Ananth Karumanchi a, Sarosh Rana a (a Beth Israel Deaconess Medical Center, Boston, MA, USA, b Massachusetts General Hospital, Boston, MA, USA, c Charité University Medicine, Berlin, Germany)
Abstracts / Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 5 (2015) 2–52
Objectives: To evaluate if placental histopathological changes of vascular insufficiency correlate with circulating angiogenic factors in patients with preeclampsia. Methods: Subjects were selected from a previous prospective cohort study of preeclampsia based on availability of plasma anti-angiogenic factor (sFlt1) and pro-angiogenic factor (PlGF) measurements and placental histology specimens. Preeclamptic patients were divided into two groups based on plasma levels of these factors described as a ratio; anti-angiogenic preeclampsia with sFlt1/PlGF ratio P85 and normal angiogenic preeclampsia with sFlt1/PlGF <85. The placental lesions of vascular insufficiency that were studied specifically included: atherosis, infarcts, syncytial knots, acute and chronic abruption, hematoma and fetal thrombosis. The data is shown as median (quartile1, quartile3) or n (%) when appropriate. Results: The anti-angiogenic preeclampsia group (N = 48) presented at an earlier gestational age (weeks) than the normal angiogenic group (N = 28); {32 (28, 34) vs. 35 (32, 36), P = 0.002}, had higher systolic blood pressure (mmHg) {154 (147, 168) vs. 147 (132, 158), P = 0.02}, delivered early (weeks) {(32 (29, 34) vs. 36 (34, 37), P < 0.001} and had lower birth weight (g) {(1,550 (1.055, 2.060) vs. 2.655 (2.285, 3.343), P < 0.001}. Several pathologic lesions were found significantly more often in the anti-angiogenic preeclampsia group; atherosis {27.7 % vs. 3.6%, P < 0.05}, infarcts {58.3% vs. 3.6%, P = 0.002} and syncytial knots {81.3% vs. 39.3%, P < 0.001}. Conclusions: Preeclamptic patients with imbalance in circulating angiogenic factors have disproportionally higher rates of placental vascular lesions historically associated with severe disease.
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Disclosures: K. Baltajian: None. J.L. Hecht: None. J.B. Wenger: None. S. Salahuddin: None. S.S. Verlohren: Consultant, Research Support Recipient, Commercial Interest: Roche Diagnostics, ThermoFisher, Novartis. F.H. Perschel: None. Z.K. Zsengeller: None. R. Thadhani: named as coinventors of patents related to use of angiogenic biomarkers in preeclampsia that are held by Harvard Hospitals, has financial interest in Aggamin LLC. S. Karumanchi: named as co-inventors of patents related to use of angiogenic biomarkers in preeclampsia that are held by Harvard Hospitals, S.A.K has financial interest in Aggamin LLC, Consultant to Siemens, and Roche diagnostics.. S. Rana: None. doi:10.1016/j.preghy.2014.10.060
[57-OR] Clonidine versus captopril for severe postpartum hypertension: A randomized controlled trial Leila Katz, Carlos Noronha Neto, Sabina Maia, Isabela Coutinho, Alex Sr Souza, Melania Mr Amorim (IMIP, Recife, Brazil) Objectives: To evaluate the effectiveness and safety of clonidine compared to captopril for treating severe postpartum hypertension. Methods: A randomized, drug-controlled, triple-blind clinical trial evaluating 90 postpartum women receiving captopril or clonidine. Inclusion criteria consisted of: women with hypertensive disorders of pregnancy [systolic blood pressure (SBP) equal or above 180 mmHg and/or