Pregnancy‐induced sympathetic overactivity: a precursor of preeclampsia<sup>*</sup>

Fischer, T.; Schobel, Hans P.; Frank, Helga; Andreae, Michael H.; Schneider, K. T. M.; Heusser, Karsten

doi:10.1111/j.1365-2362.2004.01350.x

Cited by 103 publications

(96 citation statements)

References 23 publications

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“…The QT c shortening before pathological outcomes might be reflective of elevated sympathetic nerve activity that has been described in hypertensive pregnancy disorders. 21 Based on muscular sympathetic nerve activity measurements it has been suggested that sympathetic overactivity precedes clinical symptoms of preeclampsia. 21 Clinical implications This is the first study to show that normal pregnancy leads to subtle changes in the rate adaptation of ventricular repolarization.…”

Section: Discussionmentioning

confidence: 99%

“…21 Based on muscular sympathetic nerve activity measurements it has been suggested that sympathetic overactivity precedes clinical symptoms of preeclampsia. 21 Clinical implications This is the first study to show that normal pregnancy leads to subtle changes in the rate adaptation of ventricular repolarization. These alterations might contribute to the increased occurrence of arrhythmias that have been described previously.…”

Section: Discussionmentioning

confidence: 99%

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Longitudinal changes in QT interval variability and rate adaptation in pregnancies with normal and abnormal uterine perfusion

et al. 2010

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The maternal heart significantly adapts to the circulatory needs of pregnancy, but the effect of pregnancy on ventricular repolarization is poorly understood. The aim of this study was to quantify longitudinal changes in ventricular repolarization during pregnancy. Monthly electrocardiographs (ECGs) were recorded in 32 pregnant women with normal uterine perfusion and 32 pregnant women with abnormal perfusion, starting from the 20th week of gestation until 3 days postpartum. Ventricular repolarization was assessed through various QT interval variability and heart rate adaptation measures. The pregnancy outcomes of all women with normal perfusion were normal. Among pregnancies with abnormal uterine perfusion, 15 pregnancy outcomes were normal, but 17 pregnancies developed preeclampsia and/or small-for-gestational-age infants. In pregnancies with normal perfusion, the QT c interval was unaltered, but the QT interval-heart rate hysteresis lag was shorter and the QT interval-heart rate regression residual was higher compared with those of a control group of 10 healthy non-pregnant women. Pregnancies with abnormal uterine perfusion that developed pathological outcomes showed significantly smaller QT interval-heart rate regression residuals and a trend towards shorter QT c intervals compared with pregnant women with normal perfusion. In conclusion, pregnancy has a significant effect on ventricular repolarization. Pregnancies with abnormal uterine perfusion and subsequent pathological outcomes are paralleled by changes in ventricular repolarization that precede clinical symptoms.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Longitudinal changes in QT interval variability and rate adaptation in pregnancies with normal and abnormal uterine perfusion

et al. 2010

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“…Under the conditions of preeclampsia (3,4) and GDM (5), the sympathetic nerves are activated. Moreover, patients with preeclampsia often experience sleep disruptions due to an increased frequency of movement during rapid eye movement sleep (6) and those with diabetes tend to have difficulty falling asleep (7).…”

Section: Introductionmentioning

confidence: 99%

Salivary melatonin levels and sleep-wake rhythms in pregnant women with hypertensive and glucose metabolic disorders: A prospective analysis

Shimada

Samejima

Hayase

et al. 2016

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“…pregnancy is associated with elevations in muscle sympathetic nerve activity, 4,13,14 which occur progressively across the trimesters of pregnancy. 15 This increase in baseline sympathetic activity occurs concomitantly with elevations in circulating nitric oxide and reductions in vascular resistance.…”

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confidence: 99%

Regulation of Sympathetic Nerve Activity During the Cold Pressor Test in Normotensive Pregnant and Nonpregnant Women

et al. 2015

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T he risk of developing cardiovascular disease is lower in young women when compared with similarly aged men. [1][2][3] However, pregnancy represents a period of increased susceptibility to disordered cardiovascular regulation for women. Pregnant women have an elevated risk for orthostatic intolerance. 4,5 Moreover, ≤8% of pregnancies are associated with the development of de novo hypertension. 6 The cause of such hypertensive pregnancy disorders remains unclear, and as a result, there exist few approaches by which clinicians can predict, screen, or treat the development of the hypertensive disorders of pregnancy (gestational hypertension and preeclampsia). Previous data have shown that the vascular response to the cold pressor test (CPT) is blunted in normal pregnant women compared with women in the nonpregnant, postpartum state. 8 However, an elevated pressor response to the CPT has been observed in women with 9 or who subsequently develop 10 preeclampsia. As such, the CPT has been suggested as a simple screening tool for pregnancy-related hypertensive disorders. The mechanisms driving these divergent responses remain unknown; however, sympathetic nervous system activity is a primary determinant of the pressor response to the CPT. 11Differing vascular responses to the CPT may be mediated by altered sympathetic responses or altered translation of sympathetic activity into a vascular outcome (neurovascular transduction). Studies conducted over the past 2 decades have indicated, albeit not universally, 12 that normotensive Abstract-Baseline neurovascular transduction is reduced in normotensive pregnancy; however, little is known about changes to neurovascular transduction during periods of heightened sympathetic activation. We tested the hypothesis that, despite an exacerbated muscle sympathetic nerve activity (microneurography) response to cold pressor stimulation, the blunting of neurovascular transduction in normotensive pregnant women would result in similar changes in vascular resistance and mean arterial pressure (Finometer) relative to nonpregnant controls. Baseline neurovascular transduction was reduced in pregnant women relative to controls when expressed as the quotient of both total resistance and mean arterial pressure and sympathetic burst frequency (0.

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Pregnancy‐induced sympathetic overactivity: a precursor of preeclampsia^*

Cited by 103 publications

References 23 publications

Longitudinal changes in QT interval variability and rate adaptation in pregnancies with normal and abnormal uterine perfusion

Longitudinal changes in QT interval variability and rate adaptation in pregnancies with normal and abnormal uterine perfusion

Salivary melatonin levels and sleep-wake rhythms in pregnant women with hypertensive and glucose metabolic disorders: A prospective analysis

Regulation of Sympathetic Nerve Activity During the Cold Pressor Test in Normotensive Pregnant and Nonpregnant Women

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Pregnancy‐induced sympathetic overactivity: a precursor of preeclampsia*

Cited by 103 publications

References 23 publications

Longitudinal changes in QT interval variability and rate adaptation in pregnancies with normal and abnormal uterine perfusion

Longitudinal changes in QT interval variability and rate adaptation in pregnancies with normal and abnormal uterine perfusion

Salivary melatonin levels and sleep-wake rhythms in pregnant women with hypertensive and glucose metabolic disorders: A prospective analysis

Regulation of Sympathetic Nerve Activity During the Cold Pressor Test in Normotensive Pregnant and Nonpregnant Women

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Pregnancy‐induced sympathetic overactivity: a precursor of preeclampsia^*