Published Online
on October 17, 2005

A more recent version of this article appeared on November 1, 2005

This Article Full Text (PDF) All Versions of this Article: 46/5/1123    most recent 01.HYP.0000186328.90667.95v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Khan, F. Articles by Mires, G. Search for Related Content PubMed PubMed Citation Articles by Khan, F. Articles by Mires, G. Related Collections Other hypertension Endothelium/vascular type/nitric oxide

Submitted on July 11, 2005
Revised on July 28, 2005

Changes in Endothelial Function Precede the Clinical Disease in Women in Whom Preeclampsia Develops

Faisel Khan^*; Jill J.F. Belch; Maureen MacLeod; and Gary Mires

From the Vascular Diseases Research Unit (F.K., J.J.F.B.), The Institute of Cardiovascular Research and Maternal and Child Health Sciences (M.M., G.M.), Ninewells Hospital and Medical School, University of Dundee, Dundee, Scotland, UK.

^* To whom correspondence should be addressed. E-mail: f.khan{at}dundee.ac.uk.

Abstract--Endothelial dysfunction is important in the pathophysiology of preeclampsia. No study has examined endothelial function sequentially at different gestations before development of the clinical syndrome and after delivery (to compare maternal from placental influences). We sought to determine whether endothelial function changes before the clinical development of preeclampsia. We measured skin microvascular function using iontophoresis of acetylcholine and sodium nitroprusside, and laser Doppler imaging at 22, 26, 34 weeks’ gestation and 6 weeks postpartum in women identified as being at increased risk of preeclampsia, based on uterine artery Doppler waveforms at 18 to 20 weeks, and controls with normal Doppler waveforms. Fifty-four women remained normotensive and preeclampsia developed in 15. In normotensive and preeclamptic women, acetylcholine responses were augmented during pregnancy compared with postpartum responses (P<0.001). Sodium nitroprusside responses were augmented during pregnancy compared with those postpartum (P<0.005) in preeclamptic women only. Microvascular responses were augmented in women in whom preeclampsia developed, compared with those in normotensive women, at 26 and 34 weeks for acetylcholine (P<0.05 and P<0.001, respectively) and at 22 and 26 weeks for sodium nitroprusside (P<0.05 and P<0.02, respectively). Postpartum acetylcholine and sodium nitroprusside responses were not significantly different between preeclamptic and normal women. Microvascular responses are enhanced during pregnancy in women in whom preeclampsia develops to a level above that seen in normotensive women. These changes precede the onset of clinical disease and might be related to a compensatory increased sensitivity of the microcirculation to nitric oxide.

Key words: endothelium-derived factors • hypertension • microcirculation • nitric oxide • preeclampsia • pregnancy

This article has been cited by other articles:

				B. D. LaMarca, J. Gilbert, and J. P. Granger Recent Progress Toward the Understanding of the Pathophysiology of Hypertension During Preeclampsia Hypertension, April 1, 2008; 51(4): 982 - 988. [Full Text] [PDF]

				E. Teran, C. Escudero, S. Vivero, G. Molina, and A. Calle NO in Early Pregnancy and Development of Preeclampsia Hypertension, April 1, 2006; 47(4): e17 - e17. [Full Text] [PDF]

				L. Carbillon Uterine Artery Doppler and Changes in Endothelial Function Before Clinical Disease in Preeclamptic Women Hypertension, April 1, 2006; 47(4): e16 - e16. [Full Text] [PDF]

				J. Blaauw, R. Graaff, M. G. van Pampus, J. J. van Doormaal, A. J. Smit, G. Rakhorst, J. G. Aarnoudse, F. Khan, J. J.F. Belch, M. MacLeod, et al. Changes in Endothelial Function Precede the Clinical Disease in Women in Whom Preeclampsia Develops * Response: Endothelial Function and Preeclampsia Hypertension, March 1, 2006; 47(3): e14 - e15. [Full Text] [PDF]

				S. P. Salas, G. Marshall, B. L. Gutierrez, and P. Rosso Time Course of Maternal Plasma Volume and Hormonal Changes in Women With Preeclampsia or Fetal Growth Restriction Hypertension, February 1, 2006; 47(2): 203 - 208. [Abstract] [Full Text] [PDF]