Resting peripheral blood flow in normal pregnancy and in pre-eclampsia

ANIM-NYAME, N.; SOORANNA, S.R.; JOHNSON, M.R.; GAMBLE, J.; STEER, P.J.

doi:10.1042/cs20000091

Cited by 14 publications

(19 citation statements)

References 21 publications

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“…We have previously reported a highly significant ( P 0.001) increase in permeability (K f ) in pre-eclamptic patients, relative to matched pregnant and non-pregnant controls [27]. The rise in K f will cause an increase in protein concentration at the microvascular interface, especially in the light of the reduced blood flow rate following the increased pre-capillary resistance, which is known to occur in pre-eclampsia [4,5]. However, the lack of correlation between K f and P V i in the present study suggests that the increased K f is unlikely to solely explain the elevated values of P V i in pre-eclampsia.…”

Section: Figure 3 Correlations Between P V I and K F In Non-pregnant mentioning

confidence: 94%

“…Indeed, we have recently reported that resting tissue blood flow is reduced in pregnancies complicated by pre-eclampsia [4], and that this change precedes the onset of the disease [5]. Since pre-eclampsia often presents as a multisystem disease, and end-organ failure is common, it suggests the presence of an underlying microvascular dysfunction.…”

Section: Introductionmentioning

confidence: 98%

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Evidence of impaired microvascular function in pre-eclampsia: a non-invasive study

ANIM-NYAME¹,

Gamble²,

SOORANNA³

et al. 2003

Clinical Science

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The clinical presentation of pre-eclampsia suggests that microvascular dysfunction may play a role in the maternal manifestations of the disease. Isovolumetric venous pressure ( P V(i)) is an index of microvascular function, reflecting local plasma colloid osmotic (oncotic) pressure, and is abnormal in clinical conditions with microvascular dysfunction. We hypothesized that, in pre-eclampsia, post-capillary margination of neutrophils would increase post-capillary resistance, and therefore P V(i). A small cumulative step strain-gauge plethysmography protocol was used to compare P V(i) in 18 women with pre-eclampsia, 16 normal pregnant women and 17 non-pregnant controls. Circulating levels of vascular cell-adhesion molecule-1 (VCAM-1), intercellular cell-adhesion molecule-1 (ICAM-1) and E-selectin, and neutrophil elastase, were measured to assess endothelial and neutrophil activation respectively. P V(i) was significantly greater in the pre-eclampsia group, relative to the normal pregnant and non-pregnant controls ( P <0.001, ANOVA, for both comparisons). P V(i) was significantly lower during normal pregnancy compared with the non-pregnant controls ( P =0.001). Plasma levels of neutrophil elastase, VCAM-1, ICAM-1 and E-selectin ( P =0.001) were significantly greater in the pre-eclamptics than the controls. Significant positive correlations were observed between P V(i) and neutrophil elastase ( r =0.71, P =0.001), VCAM-1 ( r =0.52, P =0.03), ICAM-1 ( r =0.67, P =0.002), E-selectin ( r =0.69, P =0.001), uric acid levels ( r =0.54, P =0.02) and haematocrit ( r =0.64, P =0.004) in pre-eclampsia. The relationship with the platelet count was negative ( r =-0.65, P =0.003). No significant correlations were observed between P V(i) and maternal age, gestational age, total protein, albumin, diastolic blood pressures, age, body mass index and infant birth mass in the normal pregnant and non-pregnant controls. These data suggest that microvascular dysfunction occurs in pre-eclampsia, and that it is related to alterations in endothelial cell and neutrophil activation.

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Section: Figure 3 Correlations Between P V I and K F In Non-pregnant mentioning

confidence: 94%

Section: Introductionmentioning

confidence: 98%

Evidence of impaired microvascular function in pre-eclampsia: a non-invasive study

ANIM-NYAME¹,

Gamble²,

SOORANNA³

et al. 2003

Clinical Science

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“…1,8,18,19 The hemodynamic alterations associated with preeclampsia are regulated by several pathways, including the adrenergic system and NO pathway. 8,19,20 However, the molecular mechanisms resulting in differences in vascular reactivity in preeclamptic and normal pregnant women remain unclear.…”

Section: Discussionmentioning

confidence: 99%

Disproportionate Decrease in α- Compared With β-Adrenergic Sensitivity in the Dorsal Hand Vein in Pregnancy Favors Vasodilation

et al. 2002

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Background-Altered vascular responses to adrenergic agonists during pregnancy are thought to play an important role in the regulation of blood pressure and placental blood flow. Because ␣ 1 -adrenergic and ␤ 2 -adrenergic sensitivity act in opposing directions to determine vascular tone, we simultaneously evaluated ␣-adrenergic-mediated vasoconstriction and ␤-adrenergic-mediated vasodilation in dorsal hand veins during and after pregnancy. Methods and Results-Twenty healthy pregnant women were studied at 32 to 37 weeks of gestation and again 12 weeks after delivery. Vascular response to phenylephrine (PE) and isoproterenol (ISO) was measured in a dorsal hand vein using the linear variable differential transformer technique. The dose of PE resulting in 50% constriction (CD 50 ) was determined. The response to ISO was measured after the PE preconstriction. Pregnant and postpartum values, expressed as geometric mean (95% CI), were compared by paired t test. ␣-Adrenergic sensitivity during pregnancy (CD 50 2. Key Words receptors, adrenergic, alpha Ⅲ receptors, adrenergic, beta Ⅲ veins Ⅲ pregnancy Ⅲ vasoconstriction I ntravascular volume is increased substantially in normal pregnancy and is accompanied by decreased arterial and venous tone and blunted vascular responses to vasoconstricting drugs and hormones. 1 Although the alterations in vascular tone and volume are necessary adaptations to the pregnant state, the molecular mechanisms underlying these hemodynamic changes are poorly understood and characterized. It is commonly stated that pregnant women have a diminished response to vasoconstricting and vasodilating drugs and endogenous vasoactive substances, but this phenomenon and its magnitude have rarely been demonstrated in vivo. The dorsal hand-vein technique with a linear variable differential transformer (LVDT) 2 allows the direct, in vivo assessment of vascular responses to a variety of agents. By using low doses of drugs acting primarily at the local segment of the vessel under study, systemic effects and the consequent reflex responses that occur after systemic administration of large doses of vasoactive drugs are avoided, 3,4 making it a particularly attractive method for studying vascular sensitivity during pregnancy. We used the LVDT dorsal hand-vein technique, with infusion of micro-doses of agonists to determine and compare ␣-and ␤-adrenergic vascular sensitivity during normal pregnancy and postpartum. MethodsAfter Institutional Review Board approval and informed written consent, 20 healthy pregnant women were studied. All women were undergoing uncomplicated, singleton pregnancies with no history of significant medical disease or pregnancy-induced hypertension and were taking no medications with the exception of prenatal vitamins. Subjects were studied twice; first between 32 to 37 weeks of gestation and then 12 weeks postpartum. Subjects refrained from cigarette and caffeine consumption for 12 hours before each session, and the studies were performed in a quiet temperature-controlled room. Subjects w...

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“…Calf blood flow was measured using the principles described in a previous protocol [17]. In the current protocol, venous congestion pressure was raised rapidly to 40 mmHg and the pressure held for 20 s. Since this pressure occludes venous return but not arterial blood inflow, the initial swelling rate will equal arterial blood flow [18].…”

Section: Study Protocolmentioning

confidence: 99%

Garlic supplementation increases peripheral blood flow: a role for interleukin-6?

Anim-Nyame

Sooranna

Johnson

et al. 2004

The Journal of Nutritional Biochemistry

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Resting peripheral blood flow in normal pregnancy and in pre-eclampsia

Cited by 14 publications

References 21 publications

Evidence of impaired microvascular function in pre-eclampsia: a non-invasive study

Evidence of impaired microvascular function in pre-eclampsia: a non-invasive study

Disproportionate Decrease in α- Compared With β-Adrenergic Sensitivity in the Dorsal Hand Vein in Pregnancy Favors Vasodilation

Garlic supplementation increases peripheral blood flow: a role for interleukin-6?

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