Czy łagodny stan przedrzucawkowy powoduje sztywność tętnic i przebudowę komory serca poprzez zapalenie?

Background: A link between preeclampsia (PE) and excessive maternal morbidity and mortality is a commonly recognized fact. Moreover, it has been suggested that chronic inflammatory state connected with PE contributes to accelerated atherosclerosis. There is also an association between PE and maternal cardiac remodeling and biventricular diastolic dysfunction. The aim of the study was to investigate the presence of impaired myocardial performance and increased arterial stiffness in patients who experienced a mild case of PE five years previously. Methods: The study included forty PE patients (40 women; mean age 33.75±7.95) and 27 healthy volunteers (27 women; mean age 36.44±10.45)Transthoracic echocardiography, including Doppler echocardiography combined with tissue Doppler imaging (TDI), and aortic stiffness index (AoSI), aortic distensibility (AoD), and aortic elastic modulus (AoEM) values were measured in each study participant. Results: There was a statistically significant increase in hsCRP, aortic stiffness index, and aortic elastic modulus in PE patients as compared to controls (2.43±1.91 vs. 3.80±2.06, p=0.007; 3.09±2.41 vs. 7.32±6.89, p=0.001; 2.89±2.11 vs. 7.00± 6.83, p=0.001), while a significant decrease was observed in the aortic strain and distensibility (respectively, 22.35±15.99 vs. 12.24±9.22, p=0.005; 11.17±9.68 vs. 6.13±4.99, p=0.018). No differences between the two groups were observed with regard to the left ventricular myocardial performance index (MPI) (0.55±0.16 vs. 0.53± 0.19, p= 0.630). Conclusions: To the best of our knowledge, this has been the first study to demonstrate impaired aortic elasticity and unaffected myocardial performance index in patients with mild PE. Moreover, these effects turned out to be significantly correlated with inflammation.Wstęp: Istnieje powiązanie pomiędzy stanem przedrzucawkowym (PE) a nadmierną zachorowalnością i śmiertelnością. Ponadto, sugeruje się, że przewlekły stan zapalny udzielający się w PE przyczynia się do przyspieszenia miażdżycy. Istnieje również związek między PE przebudowy mięśnia sercowego ze strony matki i dwukomorową dysfunkcją rozkurczową. Zaplanowaliśmy ocenić w tym badaniu, czy nie została osłabiona wydolność mięśnia sercowego oraz zwiększenie sztywności tętnic u pacjentek, które pięć lat wcześniej miały łagodny przypadek PE. Metody: W badanie włączonych zostało czterdzieści pacjentek (40 kobiet; średnia wieku 33,75±7,95) oraz 27 zdrowych ochotniczek (27 kobiet: średnia wieku: 36,44±10,45). Każda z pacjentek została zbadana za pomocą echokardiografii przezklatkowej, w tym echokardiografii dopplerowskiej w połączeniu z tkankową echokardiografią dopplerowską (TDI). Zostały również zmierzone takie wartości, jak wskaźnik sztywności aorty (AoSI), rozciągliwość aorty, a także moduł sprężystości aorty (AoEM). Wyniki: Stwierdzono statystycznie istotny wzrost hsCRP, wskaźnika sztywności aorty i modułu sprężystości aorty u pacjentów z PE w porównaniu z grupą kontrolną (2,43±1,91vs. 3,80±2,06, p=0.007; 3,09±2,41 vs. 7,32±6,89, p=0,001; 2,89±2,11 vs. 7,00± 6,83, p=0,001), natomiast znaczne zmniejszenie zaobserwowano w odkształceniu aorty i jej rozciągliwości (odpowiednio 22,35±15,99 vs. 12,24±9,22, p= 0,005; 11,17±9,68 vs. 6,13±4,99, p=0.018). Nie wystąpiły różnice pomiędzy tymi dwoma grupami w odniesieniu do wskaźnika wydolności mięśnia sercowego lewej komory (0,55± 0,16 vs 0,53± 0,19, p=0,630). Wnioski: Stwierdziliśmy po raz pierwszy w tym badaniu, że wystąpiły osłabiona elastyczność aorty i niezmieniony wskaźnik wydolność mięśnia sercowego (MPI) u pacjentek z łagodnym PE, ponadto, efekty te były znacząco skorelowane ze stanem zapalnym

Does mild preeclampsia cause arterial stiffness and ventricular remodeling through inflammation?

Background: A link between preeclampsia (PE) and excessive maternal morbidity and mortality is a commonly recognized fact. Moreover, it has been suggested that chronic inflammatory state connected with PE contributes to accelerated atherosclerosis. There is also an association between PE and maternal cardiac remodeling and biventricular diastolic dysfunction. The aim of the study was to investigate the presence of impaired myocardial performance and increased arterial stiffness in patients who experienced a mild case of PE five years previously. Methods: The study included forty PE patients (40 women; mean age 33.75 +/- 7.95) and 27 healthy volunteers (27 women; mean age 36.44 +/- 10.45) Transthoracic echocardiography, including Doppler echocardiography combined with tissue Doppler imaging (TDI), and aortic stiffness index (AoSI), aortic distensibility (AoD), and aortic elastic modulus (AoEM) values were measured in each study participant. Results: There was a statistically significant increase in hsCRP, aortic stiffness index, and aortic elastic modulus in PE patients as compared to controls (2.43 +/- 1.91 vs. 3.80 +/- 2.06, p=0.007; 3.09 +/- 2.41 vs. 7.32 +/- 6.89, p=0.001; 2.89 +/- 2.11 vs. 7.00 +/- 6.83, p=0.001), while a significant decrease was observed in the aortic strain and distensibility (respectively, 22.35 +/- 15.99 vs. 12.24 +/- 9.22, p=0.005; 11.17 +/- 9.68 vs. 6.13 +/- 4.99, p=0.018). No differences between the two groups were observed with regard to the left ventricular myocardial performance index (MPI) (0.55 +/- 0.16 vs. 0.53 +/- 0.19, p=0.630). Conclusions: To the best of our knowledge, this has been the first study to demonstrate impaired aortic elasticity and unaffected myocardial performance index in patients with mild PE. Moreover, these effects turned out to be significantly correlated with inflammation

Polycystic Ovary Syndrome: The Correlation Between Renal Doppler Ultrasound and Laboratory Parameters

Aim: To investigate whether there is alteration both right and left kidney lenght, parenchymal thickness, renal arterial, venous blood flow measurements in normotensive reproductive age women with polycystic ovary syndrome (PCOS). Material and Method: Forty women with PCOS according to Rotterdam criteria and thirty-six healthy volunteers women were included in our study. Hormonal, biochemical analysis, renal Doppler ultrasonography were performed and were investigated in terms of both left and right renal lenght, parenchymal thickness, peak systolic velocity (PSV), resistive index (RI), venous impedance index (VI), metabolic characteristics having insulin resistance, impaired glucose tolerance, serum lipid concentration. The student t test and pearson corelation test were used for statistical analysis. Results: The measurements for kidneys were not different between women with PCOS and healthy women. The peak systolic velocity of mean renal artery was lower in PCOS group. The mean renal venous impedance also was higher in PCOS group than control group. The mean renal resistive index was slightly higher in PCOS but not statistical significant. In bivariate corelation analyse including all patients, it was seen that BMI, WHR, level of serum fasting glucose, insulin, LDL, trigliserides were positively related with mean renal length and mean parenchymal thickness measurements. Discussion: We found that there was alterations kidney blood flow in normotensive reproductive age women with PCOS. This findings may indicate results of long term renal and cardiovascular complications of PCOS

Polycystic Ovary Syndrome: The Correlation Between Renal Doppler Ultrasound and Laboratory Parameters

Aim: To investigate whether there is alteration both right and left kidney lenght, parenchymal thickness, renal arterial,venous blood flow measurements in normotensive reproductive age women with polycystic ovary syndrome (PCOS). Material and Method: Forty women with PCOS according to Rotterdam criteria and thirty-six healthy volunteers women were included in our study. Hormonal, biochemical analysis, renal Doppler ultrasonography were performed and were investigated in terms of both left and right renal lenght, parenchymal thickness, peak systolic velocity (PSV), resistive index (RI), venous impedance index (VI), metabolic characteristics having insulin resistance, impaired glucose tolerance, serum lipid concentration. The student t test and pearson corelation test were used for statistical analysis.Results: The measurements for kidneys were not different between women with PCOS and healthy women. The peak systolic velocity of mean renal artery was lower in PCOS group. The mean renal venous impedance also was higher in PCOS group than control group. The mean renal resistive index was slightly higher in PCOS but not statistical significant. In bivariate corelation analyse including all patients, it was seen that BMI, WHR, level of serum fasting glucose, insulin, LDL, trigliserides were positively related with mean renal length and mean parenchymal thickness measurements. Discussion: We found that there was alterations kidney blood flow in normotensive reproductive age women with PCOS. This findings may indicate results of long term renal and cardiovascular complications of PCOS

Previous gestational diabetes history is associated with impaired coronary flow reserve

Background Gestational diabetes mellitus (GDM) is a prediabetic state that is known to increase the risk of cardiovascular diseases. We have investigated coronary flow velocity reserve (CFVR) and epicardial fat thickness (EFT), and left ventricular diastolic function in patients with a history of previous GDM (p-GDM)