Angiogenic markers and maternal echocardiographic indices in women with hypertensive disorders of pregnancy.

The maternal cardiovascular system of women with hypertensive disorders of pregnancy (HDP) can be impaired, with higher rates of left ventricular (LV) remodelling and diastolic dysfunction compared to normotensive pregnancies. The primary objective of this prospective study was to correlate cardiac indices obtained by transthoracic echocardiography (TTE) and circulating angiogenic markers, such as soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PlGF). 95 women with a pregnancy complicated by HDP and a group of 25 uncomplicated pregnancies at term underwent TTE and blood tests to measure sFlt-1 and PLGF during the peripartum period (before delivery and within a week of giving birth). Spearman's rank correlation was used to report correlation coefficients between biomarkers and cardiac indices in the HDP population and controls. HDP group included 61 (64.2%) preeclamptic patients and, among them, 42 (68.9%) delivered before 37 weeks. 12 HDP out of 95 (12.6%) patients underwent blood samples and TTE after delivery, and, as they showed significantly lower levels of angiogenic markers, they were excluded from the analysis. There was a correlation between sFlt-1 and LVMI (r=0.246, p=0.026) and E/e' (r=0.272, p=0.014) in HDP (n=83), while in controls sFlt-1 showed a correlation with RWT (r=0.409, p=0.043), lateral e' (r=-0.562, p=0.004) and E/e' (r=0.417, p=0.042). PlGF correlated with LVMI (r=-0.238, p=0.031) in HDP patients and with lateral e' (r=0.466, p=0.022) in controls. sFlt-1/PlGF ratio correlated with lateral e' (r=-0.568, p=0.004) and E/e' (r=0.428, p=0.037) in controls and with LVMI (r=0.252, p=0.022) and E/e' (r=0.269, p=0.014) in HDP. Although the current data are not able to infer causality, they confirm the intimate relationship between the maternal cardiovascular system and endothelial markers that are used both to diagnose and indicate the severity of HDP. This article is protected by copyright. All rights reserved.

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This article is protected by copyright. All rights reserved.