Carolina Mohr

Flow-mediated dilatation in the differential diagnosis of preeclampsia syndrome

BACKGROUND The preeclampsia syndrome is associated with endothelial dysfunction and the differential diagnosis between pure preeclampsia (PE) and superimposed preeclampsia (SPE) can be only be attained 12 weeks after delivery. OBJECTIVE To compare the assessment of endothelial function through flow-mediated dilatation in pregnant women with pure preeclampsia and superimposed preeclampsia. METHODS The flow-mediated dilatation of the brachial artery was carried out according to the recommendations of the International Brachial Artery Reactivity Task Force in pregnant women with preeclampsia syndrome. PE (n=14) and SPE (n=13) were diagnosed in the postpartum period according to the definitions of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. RESULTS The median of the flow-mediated dilatation (FMD) in SPE (6.0%; 1.9-10.3) was decreased in comparison with the PE (13.6%;4.4-17.1), an apparently relevant difference , but not statistically significant (p = 0.08). The FMD < 10% was detected in 30.8% of the PE cases and in 69.2% of the SPE cases (p = 0.057). Significant differences could not be detected in the morphology of the uterine arteries between the PE and SPE cases through the Doppler spectrum. CONCLUSION The FMD of the brachial artery of patients with preeclampsia syndrome was not capable of differentiating between PE and SPE. However, the data suggest that SPE is associated with worse endothelial function I comparison to PE.FUNDAMENTO: El sindrome de preeclampsia se asocia con la disfuncion endotelial y el diagnostico diferencial entre preeclampsia pura (PE) y sobreagregada (PES) solo puede realizarse 12 semanas despues del parto. OBJETIVO: Comparar la evaluacion de la funcion endotelial a traves de dilatacion mediada por flujo en gestantes con preeclampsia pura y sobreagregada. METODOS: La dilatacion mediada por flujo de la arteria braquial se realizo utilizando las recomendaciones de la International Brachial Artery Reactivity Task Force en gestantes con Sindrome de Preeclampsia. La Preeclampsia (n = 14) y preeclampsia sobreagregada (n = 13) fueron diagnosticadas en el posparto segun las definiciones del National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. RESULTADOS: El promedio de la dilatacion mediada por flujo (DMF) en la PES (6,0%; 1,9-10,3) fue reducido en comparacion con la PE (13,6%; 4,4-17,1), una disparidad aparentemente relevante, pero sin diferencia estadisticamente significativa (p = 0,08). Una DMF inferior al 10% se detecto en el 30,8% de las PE y en el 69,2% de las PES (p = 0,057). No aparecieron diferencias significativas en la comparacion entre la morfologia de las arterias uterinas de PE y PES a traves del espectro del Doppler. CONCLUSION: La DMF de la arteria braquial de pacientes con Sindrome de Preeclampsia no demostro ser un metodo capaz de diferenciar PE de PES. No obstante, los datos sugieren que la PES se asocia a una peor funcion endotelial en comparacion con la PE.

Dilatação mediada por fluxo no diagnóstico diferencial da síndrome de pré-eclâmpsia

BACKGROUND The preeclampsia syndrome is associated with endothelial dysfunction and the differential diagnosis between pure preeclampsia (PE) and superimposed preeclampsia (SPE) can be only be attained 12 weeks after delivery. OBJECTIVE To compare the assessment of endothelial function through flow-mediated dilatation in pregnant women with pure preeclampsia and superimposed preeclampsia. METHODS The flow-mediated dilatation of the brachial artery was carried out according to the recommendations of the International Brachial Artery Reactivity Task Force in pregnant women with preeclampsia syndrome. PE (n=14) and SPE (n=13) were diagnosed in the postpartum period according to the definitions of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. RESULTS The median of the flow-mediated dilatation (FMD) in SPE (6.0%; 1.9-10.3) was decreased in comparison with the PE (13.6%;4.4-17.1), an apparently relevant difference , but not statistically significant (p = 0.08). The FMD < 10% was detected in 30.8% of the PE cases and in 69.2% of the SPE cases (p = 0.057). Significant differences could not be detected in the morphology of the uterine arteries between the PE and SPE cases through the Doppler spectrum. CONCLUSION The FMD of the brachial artery of patients with preeclampsia syndrome was not capable of differentiating between PE and SPE. However, the data suggest that SPE is associated with worse endothelial function I comparison to PE.FUNDAMENTO: El sindrome de preeclampsia se asocia con la disfuncion endotelial y el diagnostico diferencial entre preeclampsia pura (PE) y sobreagregada (PES) solo puede realizarse 12 semanas despues del parto. OBJETIVO: Comparar la evaluacion de la funcion endotelial a traves de dilatacion mediada por flujo en gestantes con preeclampsia pura y sobreagregada. METODOS: La dilatacion mediada por flujo de la arteria braquial se realizo utilizando las recomendaciones de la International Brachial Artery Reactivity Task Force en gestantes con Sindrome de Preeclampsia. La Preeclampsia (n = 14) y preeclampsia sobreagregada (n = 13) fueron diagnosticadas en el posparto segun las definiciones del National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. RESULTADOS: El promedio de la dilatacion mediada por flujo (DMF) en la PES (6,0%; 1,9-10,3) fue reducido en comparacion con la PE (13,6%; 4,4-17,1), una disparidad aparentemente relevante, pero sin diferencia estadisticamente significativa (p = 0,08). Una DMF inferior al 10% se detecto en el 30,8% de las PE y en el 69,2% de las PES (p = 0,057). No aparecieron diferencias significativas en la comparacion entre la morfologia de las arterias uterinas de PE y PES a traves del espectro del Doppler. CONCLUSION: La DMF de la arteria braquial de pacientes con Sindrome de Preeclampsia no demostro ser un metodo capaz de diferenciar PE de PES. No obstante, los datos sugieren que la PES se asocia a una peor funcion endotelial en comparacion con la PE.

Dilatación mediada por flujo en el diagnóstico diferencial del síndrome de preeclampsia

BACKGROUND The preeclampsia syndrome is associated with endothelial dysfunction and the differential diagnosis between pure preeclampsia (PE) and superimposed preeclampsia (SPE) can be only be attained 12 weeks after delivery. OBJECTIVE To compare the assessment of endothelial function through flow-mediated dilatation in pregnant women with pure preeclampsia and superimposed preeclampsia. METHODS The flow-mediated dilatation of the brachial artery was carried out according to the recommendations of the International Brachial Artery Reactivity Task Force in pregnant women with preeclampsia syndrome. PE (n=14) and SPE (n=13) were diagnosed in the postpartum period according to the definitions of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. RESULTS The median of the flow-mediated dilatation (FMD) in SPE (6.0%; 1.9-10.3) was decreased in comparison with the PE (13.6%;4.4-17.1), an apparently relevant difference , but not statistically significant (p = 0.08). The FMD < 10% was detected in 30.8% of the PE cases and in 69.2% of the SPE cases (p = 0.057). Significant differences could not be detected in the morphology of the uterine arteries between the PE and SPE cases through the Doppler spectrum. CONCLUSION The FMD of the brachial artery of patients with preeclampsia syndrome was not capable of differentiating between PE and SPE. However, the data suggest that SPE is associated with worse endothelial function I comparison to PE.FUNDAMENTO: El sindrome de preeclampsia se asocia con la disfuncion endotelial y el diagnostico diferencial entre preeclampsia pura (PE) y sobreagregada (PES) solo puede realizarse 12 semanas despues del parto. OBJETIVO: Comparar la evaluacion de la funcion endotelial a traves de dilatacion mediada por flujo en gestantes con preeclampsia pura y sobreagregada. METODOS: La dilatacion mediada por flujo de la arteria braquial se realizo utilizando las recomendaciones de la International Brachial Artery Reactivity Task Force en gestantes con Sindrome de Preeclampsia. La Preeclampsia (n = 14) y preeclampsia sobreagregada (n = 13) fueron diagnosticadas en el posparto segun las definiciones del National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. RESULTADOS: El promedio de la dilatacion mediada por flujo (DMF) en la PES (6,0%; 1,9-10,3) fue reducido en comparacion con la PE (13,6%; 4,4-17,1), una disparidad aparentemente relevante, pero sin diferencia estadisticamente significativa (p = 0,08). Una DMF inferior al 10% se detecto en el 30,8% de las PE y en el 69,2% de las PES (p = 0,057). No aparecieron diferencias significativas en la comparacion entre la morfologia de las arterias uterinas de PE y PES a traves del espectro del Doppler. CONCLUSION: La DMF de la arteria braquial de pacientes con Sindrome de Preeclampsia no demostro ser un metodo capaz de diferenciar PE de PES. No obstante, los datos sugieren que la PES se asocia a una peor funcion endotelial en comparacion con la PE.