Vascular reactivity at different sites in preeclampsia-is there a correlation?

Abstract

ObjectivePreeclampsia (PET) is associated with a disordered circulatory changes in the brain and the peripheral circulation as evidenced by changes in brachial artery Flow Mediated Vascular Dilation (FMVD) and estimated Cerebral Perfusion Pressure (eCPP). This study investigates whether the peripheral circulatory changes correlate with changes in the central cerebral circulation.Study design20 normotensive, 10 PET patients were assessed. Transcranial Doppler monitoring of the middle cerebral artery in the mother was performed and we recorded Mean and Diastolic Blood Presure and Mean and Diastolic Middle Cerebral Blood Flow Velocity (MCBFV). We calculated the eCPP according to the following equation eCPP = Vmean/(Vmean-Vdiastolic) × (BPmean – BPdiastolic). Following this FMVD of the brachial artery was measured post cuff release. We assessed the maximum brachial artery dilatation in each patient. The means were compared between the groups using student t tests and Correlation coefficient between FMVD and eCPP was measured in each of the 2 groups.ResultseCPP was significantly higher in the PET vs. the normotensive group (91.4±15.7 vs 56.9±11.5) P<.001). FMVD was significantly lower in the PET than the normotensive group (5.0±2.7 vs 8.2±2.9)(P<.022). There was poor correlation between FMVD and eCPP in the 2 groups. PET (R=.546), Normotensive (R=.498)ConclusionPreeclampsia is a multisystem disorder of generalized vasculopathy with multiple organ systems being affected. This study identifies that the peripheral vascular bed (FMVD) and cerebral circulation (eCPP) undergo significant changes in preeclampsia but these changes are independent components of the disease process. Vascular dysfunction occurring in one organ system cannot be used to predict dysfunction in another organ system. ObjectivePreeclampsia (PET) is associated with a disordered circulatory changes in the brain and the peripheral circulation as evidenced by changes in brachial artery Flow Mediated Vascular Dilation (FMVD) and estimated Cerebral Perfusion Pressure (eCPP). This study investigates whether the peripheral circulatory changes correlate with changes in the central cerebral circulation. Preeclampsia (PET) is associated with a disordered circulatory changes in the brain and the peripheral circulation as evidenced by changes in brachial artery Flow Mediated Vascular Dilation (FMVD) and estimated Cerebral Perfusion Pressure (eCPP). This study investigates whether the peripheral circulatory changes correlate with changes in the central cerebral circulation. Study design20 normotensive, 10 PET patients were assessed. Transcranial Doppler monitoring of the middle cerebral artery in the mother was performed and we recorded Mean and Diastolic Blood Presure and Mean and Diastolic Middle Cerebral Blood Flow Velocity (MCBFV). We calculated the eCPP according to the following equation eCPP = Vmean/(Vmean-Vdiastolic) × (BPmean – BPdiastolic). Following this FMVD of the brachial artery was measured post cuff release. We assessed the maximum brachial artery dilatation in each patient. The means were compared between the groups using student t tests and Correlation coefficient between FMVD and eCPP was measured in each of the 2 groups. 20 normotensive, 10 PET patients were assessed. Transcranial Doppler monitoring of the middle cerebral artery in the mother was performed and we recorded Mean and Diastolic Blood Presure and Mean and Diastolic Middle Cerebral Blood Flow Velocity (MCBFV). We calculated the eCPP according to the following equation eCPP = Vmean/(Vmean-Vdiastolic) × (BPmean – BPdiastolic). Following this FMVD of the brachial artery was measured post cuff release. We assessed the maximum brachial artery dilatation in each patient. The means were compared between the groups using student t tests and Correlation coefficient between FMVD and eCPP was measured in each of the 2 groups. ResultseCPP was significantly higher in the PET vs. the normotensive group (91.4±15.7 vs 56.9±11.5) P<.001). FMVD was significantly lower in the PET than the normotensive group (5.0±2.7 vs 8.2±2.9)(P<.022). There was poor correlation between FMVD and eCPP in the 2 groups. PET (R=.546), Normotensive (R=.498) eCPP was significantly higher in the PET vs. the normotensive group (91.4±15.7 vs 56.9±11.5) P<.001). FMVD was significantly lower in the PET than the normotensive group (5.0±2.7 vs 8.2±2.9)(P<.022). There was poor correlation between FMVD and eCPP in the 2 groups. PET (R=.546), Normotensive (R=.498) ConclusionPreeclampsia is a multisystem disorder of generalized vasculopathy with multiple organ systems being affected. This study identifies that the peripheral vascular bed (FMVD) and cerebral circulation (eCPP) undergo significant changes in preeclampsia but these changes are independent components of the disease process. Vascular dysfunction occurring in one organ system cannot be used to predict dysfunction in another organ system. Preeclampsia is a multisystem disorder of generalized vasculopathy with multiple organ systems being affected. This study identifies that the peripheral vascular bed (FMVD) and cerebral circulation (eCPP) undergo significant changes in preeclampsia but these changes are independent components of the disease process. Vascular dysfunction occurring in one organ system cannot be used to predict dysfunction in another organ system.