Augmentation index and pulse wave velocity in normotensive and pre‐eclamptic pregnancies

Franz, Maximilian; Burgmann, Maximiliane; Neubauer, Anna; Zeisler, Harald; Sanani, Ramona; Gottsauner‐Wolf, Michael; Schießl, Barbara; Andreas, Martin

doi:10.1111/aogs.12145

Cited by 65 publications

(64 citation statements)

References 34 publications

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“…47 AIx values decrease in the first and second trimesters and increase during the third trimester, relative to prepregnancy values, and may even exceed prepregnancy levels in the postpartum. [46][47][48] A greater reduction in central compared to brachial systolic BP has also been identified early in pregnancy. 50 Compared to nonpregnant women, normotensive pregnant women in their third trimester have significantly lower central systolic BP ( p = 0.02), central PP ( p = 0.02), AIx ( p = 0.02), and AP ( p = 0.002).…”

Section: Normotensive Pregnancymentioning

confidence: 99%

“…34,45 More recently, these noninvasive measures are being studied to look at vasculature remodeling during pregnancy 46,47 and to determine if they are effective tools for measuring vascular differences between women with and without preeclamptic pregnancies. 48,49 Noninvasive Vascular Testing During Pregnancy…”

Section: Noninvasive Vascular Testing Measuresmentioning

confidence: 99%

Section: Preeclamptic Pregnancymentioning

confidence: 99%

“…48,49 Preeclamptic women present with differences in arterial stiffness and vascular function relative to women with normotensive pregnancies; these differences are measurable by PWA and PWV. Although research is limited, preeclampsia is consistently related to higher AIx both at the time of diagnosis 48,49 and in the third trimester compared to normal pregnancy. 56,57 While increased PWV readings have also been observed in preeclamptic compared to normal pregnancy, 49,56 the increases are much less remarkable and often do not reach statistical significance.…”

Section: Preeclamptic Pregnancymentioning

confidence: 99%

“…56,57 While increased PWV readings have also been observed in preeclamptic compared to normal pregnancy, 49,56 the increases are much less remarkable and often do not reach statistical significance. 48,58 Maternal vasculature may be altered even after delivery of the fetus and placenta. Arterial stiffness indices have been found to be elevated from a few weeks 49 up to 3 years postpartum.…”

Section: Preeclamptic Pregnancymentioning

confidence: 99%

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Preeclampsia and Vascular Function: A Window to Future Cardiovascular Disease Risk

Enkhmaa

Wall

Mehta

et al. 2016

Journal of Women's Health

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Preeclampsia affects *3%-7% of all pregnancies and is the third leading cause of maternal mortality globally. Growing evidence indicates that preeclampsia results from vascular dysfunction, which also increases the risk for future cardiovascular events. Until recently, preeclampsia was considered a disorder limited to pregnancy, which fully resolved with the delivery of the placenta; however, it is now clear that women with a history of preeclampsia have approximately double the risk of future cardiovascular events compared to women with normotensive pregnancies. The aims of this review were to describe the hemodynamic and vascular changes that occur in normal and preeclamptic pregnancies, to review noninvasive methods to test vascular function, and to discuss the associated increased cardiovascular disease risk related to preeclampsia.

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Section: Normotensive Pregnancymentioning

confidence: 99%

Section: Noninvasive Vascular Testing Measuresmentioning

confidence: 99%

Section: Preeclamptic Pregnancymentioning

confidence: 99%

Section: Preeclamptic Pregnancymentioning

confidence: 99%

Section: Preeclamptic Pregnancymentioning

confidence: 99%

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Preeclampsia and Vascular Function: A Window to Future Cardiovascular Disease Risk

Enkhmaa

Wall

Mehta

et al. 2016

Journal of Women's Health

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Personalising cardiovascular network models in pregnancy: A two‐tiered parameter estimation approach

Carson

Warrander

Johnstone

et al. 2020

Numer Methods Biomed Eng

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Uterine artery Doppler waveforms are often studied to determine whether a patient is at risk of developing pathologies such as pre‐eclampsia. Many uterine waveform indices have been developed, which attempt to relate characteristics of the waveform with the physiological adaptation of the maternal cardiovascular system, and are often suggested to be an indicator of increased placenta resistance and arterial stiffness. Doppler waveforms of four patients, two of whom developed pre‐eclampsia, are compared with a comprehensive closed‐loop model of pregnancy. The closed‐loop model has been previously validated but has been extended to include an improved parameter estimation technique that utilises systolic and diastolic blood pressure, cardiac output, heart rate, and pulse wave velocity measurements to adapt model resistances, compliances, blood volume, and the mean vessel areas in the main systemic arteries. The shape of the model‐predicted uterine artery velocity waveforms showed good agreement with the characteristics observed in the patient Doppler waveforms. The personalised models obtained now allow a prediction of the uterine pressure waveforms in addition to the uterine velocity. This allows for a more detailed mechanistic analysis of the waveforms, eg, wave intensity analysis, to study existing clinical indices. The findings indicate that to accurately estimate arterial stiffness, both pulse pressure and pulse wave velocities are required. In addition, the results predict that patients who developed pre‐eclampsia later in pregnancy have larger vessel areas in the main systemic arteries compared with the two patients who had normal pregnancy outcomes.

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Longitudinal changes in maternal hemodynamics in a population at risk for pre‐eclampsia

Khalil

Garcia-Mandujano

Maíz

et al. 2014

Ultrasound in Obstet & Gyne

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Augmentation index and pulse wave velocity in normotensive and pre‐eclamptic pregnancies

Abstract: After pregnancy, early-onset and late-onset pre-eclamptic patients exhibit differences in vascular function. This result indicates the presence of a higher cardiovascular risk in patients after early-onset pre-eclampsia.

Cited by 65 publications

References 34 publications

Preeclampsia and Vascular Function: A Window to Future Cardiovascular Disease Risk

Preeclampsia and Vascular Function: A Window to Future Cardiovascular Disease Risk

Personalising cardiovascular network models in pregnancy: A two‐tiered parameter estimation approach

Longitudinal changes in maternal hemodynamics in a population at risk for pre‐eclampsia

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