Maternal arterial stiffness in pregnancies affected by preeclampsia

Kaihura C, Savvidou MD, Anderson JM, McEniery CM, Nicolaides KH. Maternal arterial stiffness in pregnancies affected by preeclampsia. Am J Physiol Heart Circ Physiol 297: H759-H764, 2009. First published May 22, 2009; doi: 10.1152/ajpheart.01106.2008.-Preeclampsia (PE) is characterized by an aberrant maternal cardiovascular adaptation to pregnancy and increased cardiovascular risk later on in life. The aim of this study was to compare the maternal wave reflections and arterial stiffness in women with established PE and those with normotensive pregnancies, after systematic adjustment for known confounders. This was a cross-sectional study involving 69 normotensive, pregnant women and 54 women with established PE. Maternal wave reflection (augmentation index) and pulse wave velocity of the carotid-radial and carotid-femoral parts of the arterial tree were assessed noninvasively using applanation tonometry. The measurements were adjusted for maternal age, heart rate, mean arterial pressure, and aortic time to wave reflection and expressed as multiples of the median (MoM) of the control group. In the PE group, compared with controls, there was an increase in the median pulse wave velocity of both the carotid to femoral [1.1, interquartile rage (IQR) 1.0-1.3 MoM vs. 0.9, IQR 0.9-1.0 MoM; P < 0.0001] and carotid to radial (1.0, IQR 0.9-1.1 MoM vs. 0.9, IQR 0.9-1.0 MoM; P = 0.01) parts of the arterial tree. In contrast, there were no significant differences between the two groups in the median augmentation index ( 0.9, IQR 0.7-1.1 MoM vs. 1.0, IQR 0.5-1.8 MoM; P = 0.46). In conclusion, we found that established PE is characterized by increased maternal arterial stiffness but not altered maternal wave reflection.