Hemodynamic Prediction and Stratification of Hypertensive Disorders of Pregnancy: A Dream That Is Coming True?

Novelli, G. P.; Vasapollo, B.; Valensise, H.

doi:10.1161/jaha.118.010084

Cited by 7 publications

(8 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These changes start early in the first trimester with a return to the pre-pregnancy condition about one year after delivery. 54 Pregnancy represents a "cardiovascular stress test" for the mother 55 that, in case of maladaptation of the hemodynamic system, leads to the manifestation of pregnancy complications such as hypertensive disorders (HDP) and fetal growth restriction (FGR). 54,55 Substantially the result of the physiological cardiovascular adaptation is the creation of a "high flow and low resistance circulation" through an increase of blood volume (in particular of plasma volume with hemodilution), an increase in cardiovascular compliance and a creation of a hyperdynamic circle.…”

Section: Cardiovascular Changes During Pregnancy a Singleton Pregnancymentioning

confidence: 99%

“…54 Pregnancy represents a "cardiovascular stress test" for the mother 55 that, in case of maladaptation of the hemodynamic system, leads to the manifestation of pregnancy complications such as hypertensive disorders (HDP) and fetal growth restriction (FGR). 54,55 Substantially the result of the physiological cardiovascular adaptation is the creation of a "high flow and low resistance circulation" through an increase of blood volume (in particular of plasma volume with hemodilution), an increase in cardiovascular compliance and a creation of a hyperdynamic circle. These modifications lead to an adequate perfusion of the uterus which flow during pregnancy increase of about ten times respect to the pre-pregnancy condition.…”

Section: Cardiovascular Changes During Pregnancy a Singleton Pregnancymentioning

confidence: 99%

See 1 more Smart Citation

Maternal Hemodynamics from Preconception to Delivery: Research and Potential Diagnostic and Therapeutic Implications: Position Statement by Italian Association of Preeclampsia and Italian Society of Perinatal Medicine

Vasapollo,

Zullino,

Novelli

et al. 2024

Am J Perinatol

Self Cite

View full text Add to dashboard Cite

Objective The Italian Association of Preeclampsia (AIPE) and the Italian Society of Perinatal Medicine (SIMP) developed clinical questions on maternal hemodynamics state of the art. Study Design AIPE and SIMP experts were divided in small groups and were invited to propose an overview of the existing literature on specific topics related to the clinical questions proposed, developing, wherever possible, clinical and/or research recommendations based on available evidence, expert opinion, and clinical importance. Draft recommendations with a clinical rationale were submitted to 8th AIPE and SIMP Consensus Expert Panel for consideration and approval, with at least 75% agreement required for individual recommendations to be included in the final version. Results More and more evidence in literature underlines the relationship between maternal and fetal hemodynamics, as well as the relationship between maternal cardiovascular profile and fetal-maternal adverse outcomes such as fetal growth restriction and hypertensive disorders of pregnancy. Experts agreed on proposing a classification of pregnancy hypertension, complications, and cardiovascular states based on three different hemodynamic profiles depending on total peripheral vascular resistance values: hypodynamic (>1,300 dynes·s·cm−5), normo-dynamic, and hyperdynamic (<800 dynes·s·cm−5) circulation. This differentiation implies different therapeutical strategies, based drugs' characteristics, and maternal cardiovascular profile. Finally, the cardiovascular characteristics of the women may be useful for a rational approach to an appropriate follow-up, due to the increased cardiovascular risk later in life. Conclusion Although the evidence might not be conclusive, given the lack of large randomized trials, maternal hemodynamics might have great importance in helping clinicians in understanding the pathophysiology and chose a rational treatment of patients with or at risk for pregnancy complications. Key Points

show abstract

Section: Cardiovascular Changes During Pregnancy a Singleton Pregnancymentioning

confidence: 99%

Section: Cardiovascular Changes During Pregnancy a Singleton Pregnancymentioning

confidence: 99%

Maternal Hemodynamics from Preconception to Delivery: Research and Potential Diagnostic and Therapeutic Implications: Position Statement by Italian Association of Preeclampsia and Italian Society of Perinatal Medicine

Vasapollo,

Zullino,

Novelli

et al. 2024

Am J Perinatol

Self Cite

View full text Add to dashboard Cite

show abstract

“…Increased IVS values were found in Melchiore, [2,9] and Valensise. [10] According to Novelli [11] the value of IVS e proportional to the severity of gestational hypertension/preeclampsia and how long the disease last.…”

Section: Discussionmentioning

confidence: 99%

“…Significant increase p<0.001 was found in LVM in gestational hypertension group. Gestational hypertension and normotensive group was researched by Novelli [11] how found LVM increase in the gestational hypertension group.…”

Section: Discussionmentioning

confidence: 99%

Echocardiographic Heart Changes in Pregnancies Complicated with Gestation Hypertension and Preeclampsia

Kjaev

Milkovski

Karadjova

et al. 2019

ijirms

View full text Add to dashboard Cite

Introduction: Echocardiography as an imaging method is increasingly being used in obstetrics in the management of hemodynamic changes which occur in normal but also in pregnancies with gestational hypertension/preeclampsia. Aim: The aim of the study is to show that some of the heart changes in pregnancies complicated with gestational hypertension and preeclampsia are abnormal and further follow up of these patients is needed. Methods: A total of 81 patients were enrolled in the study. The patients were further divided in two groups. Pregnant women with gestational hypertension or preeclampsia (51) and a control group of normotensive pregnancies (30). A total of 3 echocardiograph exam were made, the first upon entry in the study (28 -34 g.w), the second 2 weeks after delivery and the last 6 months after delivery. Results and discussion: We found several statistically significant results that involve the IVS, PWLV, LKM, left chamber hypertrophy and diastolic function. Diastolic dysfunction usually shows up before systolic dysfunction in the evolution of ischemic/hypertensive cardiovascular disease and is of prognostic value in predicting long term cardiovascular morbidity. The changes seen 6 months after delivery on our last control mean that those changes are permanent and need further prevention strategies. Conclusion: From the noninvasive methods echocardiography is the most favorable method in identifying structural changes and functional changes in pregnancies with hypertension. Echocardiography allows fast, reproducible information and is both safe for mother and fetus.

show abstract

“…The pathophysiology of the syndromes, which were identified in the era of Hippocrates in fourth century BC, is complicated, and there is still no established therapy for the so-called toxaemia of pregnancy. 6…”

Section: Introductionmentioning

confidence: 99%

The simultaneous quantification of candidate serum biomarker peptides for hypertensive disorders of pregnancy

et al. 2019

View full text Add to dashboard Cite

Background Hypertensive disorders of pregnancy are defined as syndromes characterized by high blood pressure that develop after 20 weeks of pregnancy. The pathogenesis of hypertensive disorders of pregnancy has not been fully elucidated, and the most effective treatment is the termination of pregnancy. Therefore, methods for an early predictive diagnosis should be developed to rescue both the mother and the child. Methods Previously, we explored the serum peptides whose concentration varied specifically between patients with hypertensive disorders of pregnancy and normal pregnant women using peptidomics analysis and identified seven candidate marker peptides. To quantify the marker peptides more reliably, we attempted to quantify these peptides simultaneously by multiple reaction monitoring using liquid chromatography/tandem mass spectrometry (LC-MRM/MS). Non-labelled and stable isotope-labelled forms of the seven peptides were synthesized as standards, and the multiple reaction monitoring transitions for their quantification were determined. Results As the retention of the peptides by the reversed-phase column was dependent on their hydrophobicity, two solvent compositions were required for the retention of all peptides. Under these conditions, we detected the peptides by LC-MRM/MS using a column-switching method. Further, we succeeded in quantifying the peptides in the serum of pregnant women using stable isotope dilution. Conclusion Our new peptidomics method has great value for peptides, particularly those that have no specific antibody as a detection tool. Using this system, the serum peptides in patients with hypertensive disorders of pregnancy can be validated as diagnostic markers of hypertensive disorders of pregnancy. Further, this method can potentially be applied to the general quantification of other serum peptides.

show abstract

Hemodynamic Prediction and Stratification of Hypertensive Disorders of Pregnancy: A Dream That Is Coming True?

Cited by 7 publications

References 20 publications

Maternal Hemodynamics from Preconception to Delivery: Research and Potential Diagnostic and Therapeutic Implications: Position Statement by Italian Association of Preeclampsia and Italian Society of Perinatal Medicine

Maternal Hemodynamics from Preconception to Delivery: Research and Potential Diagnostic and Therapeutic Implications: Position Statement by Italian Association of Preeclampsia and Italian Society of Perinatal Medicine

Echocardiographic Heart Changes in Pregnancies Complicated with Gestation Hypertension and Preeclampsia

The simultaneous quantification of candidate serum biomarker peptides for hypertensive disorders of pregnancy

Contact Info

Product

Resources

About