Preeclampsia and coronary plaque erosion: Manifestations of endothelial dysfunction resulting in cardiovascular events in women

Therapeutic cell differentiatio

Cardiovascular RiskprofilE - IMaging and gender-specific disOrders (CREw-IMAGO): Rationale and design of a multicenter cohort study

Background: Reproductive disorders, such as polycystic ovary syndrome (PCOS), primary ovarian insufficiency (POI) and hypertensive pregnancy disorders (HPD) like pre-eclampsia (PE), are associated with an increased risk of cardiovascular disease (CVD). Detection of early signs of cardiovascular disease (CVD), as well as identification of risk factors among women of reproductive age which improve cardiovascular risk prediction, is a challenge and current models might underestimate long-term health risks. The aim of this study is to assess cardiovascular disease in patients with

Beyond pregnancy: development of cardiovascular disease after preeclampsia

In this thesis, we aimed to explore the cardiovascular health of women in the fifth and sixth decade of life in relation to pregnancy outcome, with a specific focus on women with preeclampsia. Additionally, we investigated the effect of uncomplicated pregnancy on arterial and metabolic health later in life. In particular, we assessed the impact of pregnancy on arterial stiffness and markers associated with arterial function, i.e. pro-NT and pro-RLX2. To explore these relationships, we investigated combined data of a number of well-established cohort studies, and conducted a newly established, multicenter prospective cohort study as part of a Dutch national consortium to promote CardiovasculaR hEalthy aging in Women (CREW consortium). Our results indicate accelerated atherosclerosis in coronary and carotid arteries after preeclampsia. Women with a history of preeclampsia showed cardiovascular abnormalities and ischemic stroke at a younger age. Further, we found that pregnancy itself is associated with increased BMI and an unfavorable CVD risk profile still present in the fifth and sixth decade of life. The results from this thesis confirm evidence for accelerated atherosclerosis in women after preeclampsia, as well as high prevalence of traditional and non-traditional cardiovascular risk factors. These results have several implications. First, the occurrence of early-age formation of coronary artery and carotid calcifications and plaques in women with previous preeclampsia confirms a shared etiological link between these two vascular disorders. Secondly, preeclampsia appears to result in cardiovascular damage at a much younger age than women without such a history. This may provide opportunities for early prevention strategies to reduce risk. However, this is expected to be a challenging task, as we still lack information about adherence, effectiveness and costs of such strategies within this group of apparently healthy young women. In conclusion, these results provide important new information on preeclampsia as a ‘failed stress test’ for cardiovascular disease, and appear to identify women with early damage to coronary arteries and other arterial atherosclerotic abnormalities. We hope these results will help to unravel paths towards early-age development of cardiovascular disease in women, and may improve care for women affected by preeclampsia

Beyond pregnancy: development of cardiovascular disease after preeclampsia

In this thesis, we aimed to explore the cardiovascular health of women in the fifth and sixth decade of life in relation to pregnancy outcome, with a specific focus on women with preeclampsia. Additionally, we investigated the effect of uncomplicated pregnancy on arterial and metabolic health later in life. In particular, we assessed the impact of pregnancy on arterial stiffness and markers associated with arterial function, i.e. pro-NT and pro-RLX2. To explore these relationships, we investigated combined data of a number of well-established cohort studies, and conducted a newly established, multicenter prospective cohort study as part of a Dutch national consortium to promote CardiovasculaR hEalthy aging in Women (CREW consortium). Our results indicate accelerated atherosclerosis in coronary and carotid arteries after preeclampsia. Women with a history of preeclampsia showed cardiovascular abnormalities and ischemic stroke at a younger age. Further, we found that pregnancy itself is associated with increased BMI and an unfavorable CVD risk profile still present in the fifth and sixth decade of life. The results from this thesis confirm evidence for accelerated atherosclerosis in women after preeclampsia, as well as high prevalence of traditional and non-traditional cardiovascular risk factors. These results have several implications. First, the occurrence of early-age formation of coronary artery and carotid calcifications and plaques in women with previous preeclampsia confirms a shared etiological link between these two vascular disorders. Secondly, preeclampsia appears to result in cardiovascular damage at a much younger age than women without such a history. This may provide opportunities for early prevention strategies to reduce risk. However, this is expected to be a challenging task, as we still lack information about adherence, effectiveness and costs of such strategies within this group of apparently healthy young women. In conclusion, these results provide important new information on preeclampsia as a ‘failed stress test’ for cardiovascular disease, and appear to identify women with early damage to coronary arteries and other arterial atherosclerotic abnormalities. We hope these results will help to unravel paths towards early-age development of cardiovascular disease in women, and may improve care for women affected by preeclampsia

Composition of thin films between emulsion droplets stabilized by protein, as measured in highly concentrated emulsions

Oil-in-water emulsions stabilized by whey protein and ß-lactoglobulin are extremely stable to coalescence, provided a saturated adsorbed protein layer is present at the droplet surfaces. If this is the case, these emulsions can be concentrated to stable highly concentrated emulsions, in which the droplets are in continuous contact and separated by thin films. The water content in these highly concentrated emulsions could be lowered to such an extent that almost all of the protein in the emulsion was present in the adsorbed layers at both sides of the thin films separating the emulsion droplets. Therefore, these systems are convenient for determination of the composition and mechanical properties of adsorbed protein layers in thin films between emulsion droplets. At the lowest water content obtained by us, the mobility of water was strongly reduced as measured by NMR, suggesting that hardly any water was present in the Plateau borders and that most of the remaining water was held within the adsorbed protein layer in the thin film regions between the emulsion droplets. The amount of protein and water remaining in the highly concentrated emulsion corresponded well with compositions of adsorbed protein layers as described in the literature, suggesting that these thin films are composed of two layers of adsorbed protei

Composition of thin films between emulsion droplets stabilized by protein, as measured in highly concentrated emulsions

Oil-in-water emulsions stabilized by whey protein and ß-lactoglobulin are extremely stable to coalescence, provided a saturated adsorbed protein layer is present at the droplet surfaces. If this is the case, these emulsions can be concentrated to stable highly concentrated emulsions, in which the droplets are in continuous contact and separated by thin films. The water content in these highly concentrated emulsions could be lowered to such an extent that almost all of the protein in the emulsion was present in the adsorbed layers at both sides of the thin films separating the emulsion droplets. Therefore, these systems are convenient for determination of the composition and mechanical properties of adsorbed protein layers in thin films between emulsion droplets. At the lowest water content obtained by us, the mobility of water was strongly reduced as measured by NMR, suggesting that hardly any water was present in the Plateau borders and that most of the remaining water was held within the adsorbed protein layer in the thin film regions between the emulsion droplets. The amount of protein and water remaining in the highly concentrated emulsion corresponded well with compositions of adsorbed protein layers as described in the literature, suggesting that these thin films are composed of two layers of adsorbed protei

Emulsion flocculation induced by saliva and mucin

Upon consumption of emulsions, mixing with saliva occurs. This article shows that whole saliva and a model mucin (pig gastric mucin, PGM) are able to induce extensive droplet flocculation. Saliva samples collected from several subjects at different times of the day always showed flocculation. However, there was a clear variation between samples from different individuals with respect to the structure of the flocs and reversibility of flocculation upon dilution. Several aspects of PGM-induced flocculation, measured by microscopy, particle size analysis, demixing experiments and rheology pointed to depletion flocculation as the main mechanism of flocculation. However, although depletion may also be an important driving force in saliva-induced flocculation, the required mucin concentration seems to be considerably lower than for PGM. Therefore other interactions, such as bridging or specific binding, may be important as well. The observed aggregation is expected to have implications for understanding sensory properties of emulsions. The viscosities of emulsions measured in vitro in the absence of saliva may deviate from the in vivo viscosities relevant for sensory perception, especially in case of liquid emulsions in which the droplets are not flocculated, such as mil

Emulsion flocculation induced by saliva and mucin

Upon consumption of emulsions, mixing with saliva occurs. This article shows that whole saliva and a model mucin (pig gastric mucin, PGM) are able to induce extensive droplet flocculation. Saliva samples collected from several subjects at different times of the day always showed flocculation. However, there was a clear variation between samples from different individuals with respect to the structure of the flocs and reversibility of flocculation upon dilution. Several aspects of PGM-induced flocculation, measured by microscopy, particle size analysis, demixing experiments and rheology pointed to depletion flocculation as the main mechanism of flocculation. However, although depletion may also be an important driving force in saliva-induced flocculation, the required mucin concentration seems to be considerably lower than for PGM. Therefore other interactions, such as bridging or specific binding, may be important as well. The observed aggregation is expected to have implications for understanding sensory properties of emulsions. The viscosities of emulsions measured in vitro in the absence of saliva may deviate from the in vivo viscosities relevant for sensory perception, especially in case of liquid emulsions in which the droplets are not flocculated, such as mil

Preparation and sensory perception of fat-free foams : Effect of matrix properties and level of aeration

The sensory perception of fat-free model foams with a consistency between pourable (liquid; xanthan thickened) and spoonable (semi-solid; gelled; carrageenan thickened) and varying level of aeration was studied. At low air contents (5, 10% v/v) perception is largely determined by the matrix properties; the presence of air is hardly experienced. On the other hand, at high levels of aeration (80% v/v) perception is determined by bubble characteristics and the matrix plays a negligible role in perception. Bubbles were better noticeable in a semi-solid, i.e. carrageenan matrix, than in liquid, i.e. xanthan-based foams. In semi-solid sucrose¿ester carrageenan foams, large bubbles were perceived as more airy and less creamy, compared with the same compositions with smaller bubbles

Partial coalescence as a tool to control sensory perception of emulsions

This study evaluates the role of partial coalescence of whey protein-stabilized emulsions on sensory perception. The selection of fats was restricted to vegetable fats that are essentially melted at oral temperatures. The sensitivity to partial coalescence was controlled by a variation in the fat melting curve and by addition of unsaturated monoglyceride. Most fat-related sensory attributes appear to be well-correlated to an increase in viscosity and coalescence in the mouth due to partial coalescence. Moreover, it was found that in-mouth aeration induces extra coalescence, which increases the perception of fat-related sensory attributes significantly. Monoglyceride addition induces a shift of the sensory perception of fattiness and other fat-related attributes. There are clear indications that monoglyceride addition affects sensory perception not only by promoting partial coalescence, but also by an additional effect such as its surface activity