- Email: [email protected]
PP055. Uric acid correlates with uterine artery vascular resistance, but not with uterine artery pulsatility index
86
Poster Presentations / Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 3 (2013) 67–99
examined in placental tissue from normal pregnant and reduced uterine perfusion pressure (RUPP) rats. Results: Positive staining for PGC-1a was noted in both human and rat placental tissue with varying levels of expression. Staining appeared to be localised to the vascular endothelial cells, trophoblasts and syncytiotrophoblasts, with some minor staining in the maternal decidua and stroma. Moreover, intensity of staining for PGC-1a appeared reduced in placental tissue from RUPP rats. Conclusion: This study indicates that PGC-1a strongly localised to endothelial cells in both human and rat placental tissue. Furthermore, our data may implicate PGC-1a in the pathogenesis of pre-eclampsia, but further research is needed. Future studies could suggest the use of PGC-1a as a future drug target for treatment of complicated pregnancies.
doi:10.1016/j.preghy.2013.04.080
PP054. Elevated maternal plasma glycogen phosphorylase isoenzyme BB as time of disease biomarker of preeclampsia and small-for-gestational-age Kenny Louise, Doyle Aisling, Khashan Ali Introduction: Glycogen phosphorylase isoenzyme BB (GPBB) is a marker of acute coronary syndromes. Preeclampsia (PE) and coronary syndrome share several aetiological and pathophysiological features. GPBB levels have previously been found to be elevated in pregnancy and preterm PE. Objectives: We conducted 6 case-control studies within the SCOPE Ireland cohort to investigate whether plasma GPBB levels are altered at time of disease presentation and to examine if GPBB has any power as a predictive biomarker at earlier gestations. Methods Blood samples were taken at time of presentation with PE (n = 25) and SGA (n = 23) and also at 15 and 20 weeks gestation for PE with no SGA (n = 33), PE and SGA (n = 18), SGA no PE with gestational hypertension (GH) (n = 25) and no GH (n = 25). All were matched to uncomplicated pregnancy controls. GPBB plasma concentration was measured with GPBB-ELISA kits (Diagenics, Germany). Results: The plasma GPBB concentration at disease presentation with PE and SGA was significantly higher than in normal uncomplicated pregnancies. There was no difference in plasma GPBB levels at 15 or 20 weeks’ gestation in women who subsequently developed PE or SGA compared with controls. Conclusion: Plasma GPBB is increased at time of presentation with PE and SGA suggesting that plasma GPBB is a biomarker of uteroplacental insufficiency. However, we found no evidence to support its use as an early pregnancy biomarker as it was not significantly elevated at 15 or 20 weeks’ gestation. doi:10.1016/j.preghy.2013.04.081
PP055. Uric acid correlates with uterine artery vascular resistance, but not with uterine artery pulsatility index Flo Kari, Vårtun Åse, Wilsgaard Tom, Acharya Ganesh Introduction: Studies indicate that uric acid is involved in the development of hypertensive diseases of pregnancy, and that uric acid might influence the remodeling of the spiral arteries. Objective: To investigate the relationship with uric acid and utero-placental hemodynamics in the second half of pregnancy. Methods: 53 women with uncomplicated pregnancies were examined longitudinally at 4-weekly intervals from 22 to 40 weeks of gestation. Blood samples for plasma uric acid were analyzed (enzymatic colorimetric method. Instrument: Modular P, Roche Diagnostic), and blood pressure (BP) was measured. Uterine artery Doppler velocity waveforms were obtained, and vessel diameter was measured bilaterally. Uterine artery volume blood flow (Quta) was calculated as the product of mean velocity and cross-sectional area of the vessel. Mean arterial pressure (MAP) was calculated as: diastolic BP + (systolic BP – diastolic BP)/3. Uterine artery resistance (Rquta) was calculated as: MAP/Quta. Uterine artery pulsatility index (UtaPI) was calculated as: (peak systolic velocity – end-diastolic velocity)/time-averaged maximum velocity. Linear mixed models and linear regression models were used for statistical analysis. Results: 242 blood samples were analyzed. Uric acid increased from 176 to 238 lmol/L. Rquta and UtaPI decreased from 0.26 to 0.13 mmHg/ml/min and 0.8–0.6 respectively. Uric acid was significantly correlated to Rquta (p = 0.005), but not to Uta PI (p = 0.178). Conclusion: There is a strong association between uric acid and uterine artery vascular resistance during the second half of pregnancy indicating that uric acid might play a role in establishing low resistance blood flow in the uteroplacental compartment.
doi:10.1016/j.preghy.2013.04.082
PP056. Cardiac adaptation in the preclinical phase of recurrent preeclampsia in women with a history of early preeclampsia Ghossein-Doha Chahinda, van Kuijk Sander, Delhaas Tammo, Peeters Louis, Spaanderman Marc Introduction: Preeclampsia is thought to be preceded by first trimester circulatory maladaptation. Early and late onset PE may exhibit two different cardiac and hemodynamic states. Moreover, early PE relates to postpartum impaired cardiac function. Incomplete resolved or impaired cardiac function may influence the pattern of cardiac adaptation in the next pregnancy and may relate to recurrent disease. We postulate that in women with a history of early PE, the pattern of early cardiac adaptation differs between those that do and those that do not develop recurrent disease.
Poster Presentations / Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 3 (2013) 67–99
Objectives: We hypothesize that after early onset PE, in the subsequent gestation, the pattern of cardiac adaptation differs between those that do and those that do not develop recurrent disease. Methods: In this cohort study, we included 84 women with a history of early-onset PE. Former PE patients who concomitantly experienced HELLP-syndrome, fetal growth restriction and/or fetal demise, were excluded. The remaining 51 women underwent serial cardiac ultrasound and automated blood pressure and heart rate recordings, once before, and again at gestational age 12, 16 and 20 weeks. Post hoc, women were subdivided into those who did (RECUR) or did not develop recurrent PE (CONTR). We analyzed data using repeated measures analysis of variance. Results: 14/51 (27%) women developed recurrent PE. Prepregnant heart rate was higher (71 vs 64 bpm, p < 0.05) and stroke volume lower (68 vs 77 mL, p < 0.05) in RECUR as compared to CONTR. Even though LVM index was consis-
87
tently lower in the RECUR group, the two subgroups responded to the next pregnancy with a comparable pattern of cardiac adaptation. Conclusion: Despite consistently lower LVM and SV and higher HR, after early onset PE, the pattern of subsequent early pregnancy cardiac adaptation is comparable in those that do and do not develop recurrent disease. doi:10.1016/j.preghy.2013.04.083
PP057. ENOSI4 and EPHX1 polymorphisms affect maternal susceptibility topreeclampsia – Analysis of five polymorphisms predisposing to cardiovascular disease in 279 caucasian and 241 african women Groten Tanja, Schlembach Dietmar, Zeillinger Robert, Holzer Barbara Objectives: Clinical studies have documented a familiar tendency to develop preeclampsia and patients with
Poster Presentations / Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 3 (2013) 67–99
examined in placental tissue from normal pregnant and reduced uterine perfusion pressure (RUPP) rats. Results: Positive staining for PGC-1a was noted in both human and rat placental tissue with varying levels of expression. Staining appeared to be localised to the vascular endothelial cells, trophoblasts and syncytiotrophoblasts, with some minor staining in the maternal decidua and stroma. Moreover, intensity of staining for PGC-1a appeared reduced in placental tissue from RUPP rats. Conclusion: This study indicates that PGC-1a strongly localised to endothelial cells in both human and rat placental tissue. Furthermore, our data may implicate PGC-1a in the pathogenesis of pre-eclampsia, but further research is needed. Future studies could suggest the use of PGC-1a as a future drug target for treatment of complicated pregnancies.
doi:10.1016/j.preghy.2013.04.080
PP054. Elevated maternal plasma glycogen phosphorylase isoenzyme BB as time of disease biomarker of preeclampsia and small-for-gestational-age Kenny Louise, Doyle Aisling, Khashan Ali Introduction: Glycogen phosphorylase isoenzyme BB (GPBB) is a marker of acute coronary syndromes. Preeclampsia (PE) and coronary syndrome share several aetiological and pathophysiological features. GPBB levels have previously been found to be elevated in pregnancy and preterm PE. Objectives: We conducted 6 case-control studies within the SCOPE Ireland cohort to investigate whether plasma GPBB levels are altered at time of disease presentation and to examine if GPBB has any power as a predictive biomarker at earlier gestations. Methods Blood samples were taken at time of presentation with PE (n = 25) and SGA (n = 23) and also at 15 and 20 weeks gestation for PE with no SGA (n = 33), PE and SGA (n = 18), SGA no PE with gestational hypertension (GH) (n = 25) and no GH (n = 25). All were matched to uncomplicated pregnancy controls. GPBB plasma concentration was measured with GPBB-ELISA kits (Diagenics, Germany). Results: The plasma GPBB concentration at disease presentation with PE and SGA was significantly higher than in normal uncomplicated pregnancies. There was no difference in plasma GPBB levels at 15 or 20 weeks’ gestation in women who subsequently developed PE or SGA compared with controls. Conclusion: Plasma GPBB is increased at time of presentation with PE and SGA suggesting that plasma GPBB is a biomarker of uteroplacental insufficiency. However, we found no evidence to support its use as an early pregnancy biomarker as it was not significantly elevated at 15 or 20 weeks’ gestation. doi:10.1016/j.preghy.2013.04.081
PP055. Uric acid correlates with uterine artery vascular resistance, but not with uterine artery pulsatility index Flo Kari, Vårtun Åse, Wilsgaard Tom, Acharya Ganesh Introduction: Studies indicate that uric acid is involved in the development of hypertensive diseases of pregnancy, and that uric acid might influence the remodeling of the spiral arteries. Objective: To investigate the relationship with uric acid and utero-placental hemodynamics in the second half of pregnancy. Methods: 53 women with uncomplicated pregnancies were examined longitudinally at 4-weekly intervals from 22 to 40 weeks of gestation. Blood samples for plasma uric acid were analyzed (enzymatic colorimetric method. Instrument: Modular P, Roche Diagnostic), and blood pressure (BP) was measured. Uterine artery Doppler velocity waveforms were obtained, and vessel diameter was measured bilaterally. Uterine artery volume blood flow (Quta) was calculated as the product of mean velocity and cross-sectional area of the vessel. Mean arterial pressure (MAP) was calculated as: diastolic BP + (systolic BP – diastolic BP)/3. Uterine artery resistance (Rquta) was calculated as: MAP/Quta. Uterine artery pulsatility index (UtaPI) was calculated as: (peak systolic velocity – end-diastolic velocity)/time-averaged maximum velocity. Linear mixed models and linear regression models were used for statistical analysis. Results: 242 blood samples were analyzed. Uric acid increased from 176 to 238 lmol/L. Rquta and UtaPI decreased from 0.26 to 0.13 mmHg/ml/min and 0.8–0.6 respectively. Uric acid was significantly correlated to Rquta (p = 0.005), but not to Uta PI (p = 0.178). Conclusion: There is a strong association between uric acid and uterine artery vascular resistance during the second half of pregnancy indicating that uric acid might play a role in establishing low resistance blood flow in the uteroplacental compartment.
doi:10.1016/j.preghy.2013.04.082
PP056. Cardiac adaptation in the preclinical phase of recurrent preeclampsia in women with a history of early preeclampsia Ghossein-Doha Chahinda, van Kuijk Sander, Delhaas Tammo, Peeters Louis, Spaanderman Marc Introduction: Preeclampsia is thought to be preceded by first trimester circulatory maladaptation. Early and late onset PE may exhibit two different cardiac and hemodynamic states. Moreover, early PE relates to postpartum impaired cardiac function. Incomplete resolved or impaired cardiac function may influence the pattern of cardiac adaptation in the next pregnancy and may relate to recurrent disease. We postulate that in women with a history of early PE, the pattern of early cardiac adaptation differs between those that do and those that do not develop recurrent disease.
Poster Presentations / Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 3 (2013) 67–99
Objectives: We hypothesize that after early onset PE, in the subsequent gestation, the pattern of cardiac adaptation differs between those that do and those that do not develop recurrent disease. Methods: In this cohort study, we included 84 women with a history of early-onset PE. Former PE patients who concomitantly experienced HELLP-syndrome, fetal growth restriction and/or fetal demise, were excluded. The remaining 51 women underwent serial cardiac ultrasound and automated blood pressure and heart rate recordings, once before, and again at gestational age 12, 16 and 20 weeks. Post hoc, women were subdivided into those who did (RECUR) or did not develop recurrent PE (CONTR). We analyzed data using repeated measures analysis of variance. Results: 14/51 (27%) women developed recurrent PE. Prepregnant heart rate was higher (71 vs 64 bpm, p < 0.05) and stroke volume lower (68 vs 77 mL, p < 0.05) in RECUR as compared to CONTR. Even though LVM index was consis-
87
tently lower in the RECUR group, the two subgroups responded to the next pregnancy with a comparable pattern of cardiac adaptation. Conclusion: Despite consistently lower LVM and SV and higher HR, after early onset PE, the pattern of subsequent early pregnancy cardiac adaptation is comparable in those that do and do not develop recurrent disease. doi:10.1016/j.preghy.2013.04.083
PP057. ENOSI4 and EPHX1 polymorphisms affect maternal susceptibility topreeclampsia – Analysis of five polymorphisms predisposing to cardiovascular disease in 279 caucasian and 241 african women Groten Tanja, Schlembach Dietmar, Zeillinger Robert, Holzer Barbara Objectives: Clinical studies have documented a familiar tendency to develop preeclampsia and patients with