Angiogenic markers and maternal echocardiographic indices in women with hypertensive disorders of pregnancy

Journal article

Giorgione, V., Di Fabrizio, C., Giallongo, E., Khalil, A., O'Driscoll, J., Whitley, G., Kennedy, G., Murdoch, C. E. and Thilaganathan, B. 2023. Angiogenic markers and maternal echocardiographic indices in women with hypertensive disorders of pregnancy. Ultrasound in Obstetrics & Gynecology. https://doi.org/10.1002/uog.27474
AuthorsGiorgione, V., Di Fabrizio, C., Giallongo, E., Khalil, A., O'Driscoll, J., Whitley, G., Kennedy, G., Murdoch, C. E. and Thilaganathan, B.
Abstract

Objective
The maternal cardiovascular system of women with hypertensive disorders of pregnancy (HDP) can be impaired, with higher rates of left ventricular (LV) remodelling and diastolic dysfunction compared to normotensive pregnancies. The primary objective of this prospective study was to correlate cardiac indices obtained by transthoracic echocardiography (TTE) and circulating angiogenic markers, such as soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PlGF).

Methods
95 women with a pregnancy complicated by HDP and a group of 25 uncomplicated pregnancies at term underwent TTE and blood tests to measure sFlt-1 and PLGF during the peripartum period (before delivery and within a week of giving birth). Spearman's rank correlation was used to report correlation coefficients between biomarkers and cardiac indices in the HDP population and controls.

Results
HDP group included 61 (64.2%) preeclamptic patients and, among them, 42 (68.9%) delivered before 37 weeks. 12 HDP out of 95 (12.6%) patients underwent blood samples and TTE after delivery, and, as they showed significantly lower levels of angiogenic markers, they were excluded from the analysis. There was a correlation between sFlt-1 and LVMI (r=0.246, p=0.026) and E/e’ (r=0.272, p=0.014) in HDP (n=83), while in controls sFlt-1 showed a correlation with RWT (r=0.409, p=0.043), lateral e’ (r=-0.562, p=0.004) and E/e’ (r=0.417, p=0.042). PlGF correlated with LVMI (r=-0.238, p=0.031) in HDP patients and with lateral e’ (r=0.466, p=0.022) in controls. sFlt-1/PlGF ratio correlated with lateral e’ (r=-0.568, p=0.004) and E/e’ (r=0.428, p=0.037) in controls and with LVMI (r=0.252, p=0.022) and E/e’ (r=0.269, p=0.014) in HDP.

Conclusions
Although the current data are not able to infer causality, they confirm the intimate relationship between the maternal cardiovascular system and endothelial markers that are used both to diagnose and indicate the severity of HDP.

KeywordsHypertensive disorders of pregnancy; Preeclampsia; Angiogenic markers; sFlt-1; PIGF; Cardiovascular; Echocardiography
Year2023
JournalUltrasound in Obstetrics & Gynecology
PublisherWiley
ISSN0960-7692
1469-0705
Digital Object Identifier (DOI)https://doi.org/10.1002/uog.27474
Official URLhttps://obgyn.onlinelibrary.wiley.com/doi/10.1002/uog.27474
Publication dates
Online07 Sep 2023
Publication process dates
Accepted24 Aug 2023
Deposited18 Sep 2023
Accepted author manuscript
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Output statusPublished
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A 4-week resistance training intervention improves stability, strength and neuromuscular activity in the lower limb: a case study of a cerebral palsy adult
McManus, A., Bembridge, M., Scales, J., Wiles, J., Coleman, D. and O'Driscoll, J. 2018. A 4-week resistance training intervention improves stability, strength and neuromuscular activity in the lower limb: a case study of a cerebral palsy adult. International Journal of Sports Science & Medicine. 2 (2), pp. 050-055.
Neurohumoral and ambulatory haemodynamic adaptations following isometric exercise training in unmedicated hypertensive patients
Taylor, K., Wiles, J., Coleman, D., Leeson, P., Sharma, R. and O'Driscoll, J. 2018. Neurohumoral and ambulatory haemodynamic adaptations following isometric exercise training in unmedicated hypertensive patients. Journal of Hypertension. https://doi.org/10.1097/HJH.0000000000001922
Cardiac autonomic and left ventricular mechanics following high intensity interval training: a randomised cross-over controlled study.
O'Driscoll, J., Wrigth, S., Taylor, K., Coleman, D., Sharma, R. and Wiles, J. 2018. Cardiac autonomic and left ventricular mechanics following high intensity interval training: a randomised cross-over controlled study. Journal of Applied Physiology. https://doi.org/10.1152/japplphysiol.00056.2018
Cardiac maladaptation in term pregnancies with preeclampsia
Buddeberg, B., Sharma, R., O'Driscoll, J., Kaelin Agten, A., Khalil, A. and Thilaganathan, B. 2018. Cardiac maladaptation in term pregnancies with preeclampsia. Pregnancy Hypertension. 13, pp. 198-203. https://doi.org/10.1016/j.preghy.2018.06.015
The safety of isometric exercise: rethinking the exercise prescription paradigm for those with stage 1 hypertension.
Wiles, J., Taylor, K., Coleman, D., Sharma, R. and O'Driscoll, J. 2018. The safety of isometric exercise: rethinking the exercise prescription paradigm for those with stage 1 hypertension. Medicine. 97 (10). https://doi.org/10.1097/MD.0000000000010105
An alternative approach to isometric exercise training prescription for cardiovascular health
Wiles, J., Goldring, N., O'Driscoll, J., Taylor, K. and Coleman, D. 2018. An alternative approach to isometric exercise training prescription for cardiovascular health. Translational Journal of the American College of Sports Medicine. 3 (2), pp. 10-18. https://doi.org/10.1249/TJX.0000000000000052
Baseline mitral regurgitation predicts outcome in patients referred for dobutamine stress echocardiography
O'Driscoll, J., Gargallo-Fernandez, P., Araco, M., Perez-Lopez, M. and Sharma, R. 2017. Baseline mitral regurgitation predicts outcome in patients referred for dobutamine stress echocardiography. International Journal of Cardiovascular Imaging. https://doi.org/10.1007/s10554-017-1163-6
Blood pressure responses to isometric exercise: safety considerations for exercise prescription
Wiles, J., Taylor, K., Coleman, D., Sharma, R. and O'Driscoll, J. 2017. Blood pressure responses to isometric exercise: safety considerations for exercise prescription.
Ambulatory blood pressure responses to home-based isometric exercise training in pre-hypertensive males
Taylor, K., Wiles, J., Coleman, D., Sharma, R. and O'Driscoll, J. 2017. Ambulatory blood pressure responses to home-based isometric exercise training in pre-hypertensive males.
Cardiac autonomic modulation and high intensity interval training in physically inactive men
O'Driscoll, J., Wright, S., Taylor, K., Coleman, D. and Wiles, J. 2017. Cardiac autonomic modulation and high intensity interval training in physically inactive men.
A higher effort-based paradigm in physical activity and exercise for public health: making the case for a greater emphasis on resistance training
Steele, J., Fisher, J., Skivington, M., Dunn, C., Arnold, J., Tew, G., Batterham, A., Nunan, D., O'Driscoll, J., Mann, S., Beedie, C., Jobson, S., Smith, D., Vigotsky, A., Phillips, S., Estabrooks, P. and Winett, R. 2017. A higher effort-based paradigm in physical activity and exercise for public health: making the case for a greater emphasis on resistance training. BMC Public Health. https://doi.org/10.1186/s12889-017-4209-8
Continuous cardiac autonomic and haemodynamic responses to isometric exercise in pre-hypertensive males
Taylor, K., Wiles, J., Coleman, D., Sharma, R. and O'Driscoll, J. 2017. Continuous cardiac autonomic and haemodynamic responses to isometric exercise in pre-hypertensive males. Medicine & Science in Sports & Exercise (MSSE). https://doi.org/10.1249/MSS.0000000000001271
Acute cardiac functional and mechanical responses to isometric exercise in pre-hypertensive males
O'Driscoll, J., Taylor, K., Wiles, J., Coleman, D. and Sharma, R. 2017. Acute cardiac functional and mechanical responses to isometric exercise in pre-hypertensive males. Physiological Reports. https://doi.org/10.14814/phy2.13236
Body mass index mortality paradox in chronic kidney disease patients with suspected cardiac chest pain
O'Driscoll, J., Slee, A. and Sharma, R. 2017. Body mass index mortality paradox in chronic kidney disease patients with suspected cardiac chest pain. Journal of Cachexia, Sarcopenia and Muscle Clinical Reports. 2 (1).
Strongman training – Needs analysis and integration into strength and conditioning programming: part 2.
McManus, A., O'Driscoll, J., Coleman, D. and Wiles, J. 2016. Strongman training – Needs analysis and integration into strength and conditioning programming: part 2. Professional Strength & Conditioning. 44, pp. 7-15.
Strongman training – a rationale for its inclusion in strength & conditioning: part 1
McManus, A., Wiles, J., Coleman, D. and O'Driscoll, J. 2016. Strongman training – a rationale for its inclusion in strength & conditioning: part 1. Professional Strength & Conditioning. 43, pp. 7-18.
Acute cardiac autonomic responses to an incremental isometric exercise test in pre-hypertensive males
Taylor, K., Wiles, J., Coleman, D., Sharma, R. and O'Driscoll, J. 2016. Acute cardiac autonomic responses to an incremental isometric exercise test in pre-hypertensive males.
Transthoracic echocardiography provides important long-term prognostic information in selected patients undergoing endovascular abdominal aortic repair
O'Driscoll, J., Bahia, S., Gravina, A., Di Fino, S., Thompson, M., Karthikesalingam, A., Holt, P. and Sharma, R. 2016. Transthoracic echocardiography provides important long-term prognostic information in selected patients undergoing endovascular abdominal aortic repair. Circulation Cardiovascular Imaging. https://doi.org/10.1161/CIRCIMAGING.115.003557
Reverse left ventricular remodelling - effect of cardiac rehabilitation exercise training in myocardial infarction patients with preserved ejection fraction
McGregor, G., Gaze, D., Oxborough, D., O'Driscoll, J. and Shave, R. 2015. Reverse left ventricular remodelling - effect of cardiac rehabilitation exercise training in myocardial infarction patients with preserved ejection fraction. European Journal of Physcial and Rehabilitation Medicine. 52 (3), pp. 370-378.
The prognostic value of dobutamine stress echocardiography amongst British Indian Asian and Afro-Caribbean patients: a comparison with European white patients
O'Driscoll, J., Rossato, C., Gargallo-Fernandez, P., Araco, M., Giannoglou, D., Sharma, S. and Sharma, R. 2015. The prognostic value of dobutamine stress echocardiography amongst British Indian Asian and Afro-Caribbean patients: a comparison with European white patients. Cardiovascular Ultrasound. 13 (36). https://doi.org/10.1186/s12947-015-0028-1
Non-invasive assessment of the autonomic nervous system
O'Driscoll, J. and Sharma, R. 2015. Non-invasive assessment of the autonomic nervous system. International Journal of Clinical Therapeutics and Diagnosis. 3 (3), pp. 85-91.
Differing autonomic responses to dobutamine stress in the presence and absence of myocardial ischaemia
Sharma, R., O'Driscoll, J., Saha, A., Sritharan, M., Sutton, R. and Rosen, S. 2015. Differing autonomic responses to dobutamine stress in the presence and absence of myocardial ischaemia. The Journal of Physiology. 593 (9), pp. 2171-2184. https://doi.org/10.1113/JP270063
The safety and clinical usefulness of dobutamine stress echocardiography among octogenarians
O'Driscoll, J., Marciniak, A., Ray, K., Schmid, K., Smith, R. and Sharma, R. 2014. The safety and clinical usefulness of dobutamine stress echocardiography among octogenarians. Heart. 2014 (100), pp. 1001-1007. https://doi.org/10.1136/heartjnl-2013-305229
The implementation of problem based learning styles to teach the Coach-Athlete relationship to undergraduate Sport and Exercise Science students
Rossato, C. and O'Driscoll, J. 2013. The implementation of problem based learning styles to teach the Coach-Athlete relationship to undergraduate Sport and Exercise Science students. International Journal of Sport Studies. 3, pp. 859-864.
Differing autonomic responses to dobutamine stress in the presence and absence of myocardial ischaemia
Sharma, R., O'Driscoll, J., Bromley, P., Sritharan, M. and Rosen, S. 2008. Differing autonomic responses to dobutamine stress in the presence and absence of myocardial ischaemia.
Dobutamine stress echocardiography accurately detects significant coronary artery disease in Indian Asians living in the United Kingdom
Itam, S., O'Driscoll, J., Milad, E. and Sharma, R. 2008. Dobutamine stress echocardiography accurately detects significant coronary artery disease in Indian Asians living in the United Kingdom.
The effects of a high-protein, paleolithic-type diet on body composition and exercise performance in amateur mixed martial artists
Slee, A., O'Driscoll, J., Burnet, S., Hughes, G. and Chen, M. 2009. The effects of a high-protein, paleolithic-type diet on body composition and exercise performance in amateur mixed martial artists.
Subjective global assessment is an independent predictor of cardiac ischaemia in patients with mild chronic kidney disease
Aldous, G., Sharma, R., O'Driscoll, J., Ashby, D., Tarn, F. and Choi, P. 2010. Subjective global assessment is an independent predictor of cardiac ischaemia in patients with mild chronic kidney disease.
A National Health Service hospital's cardiac rehabilitation programme: a qualitative analysis of provision
O'Driscoll, J., Shave, R. and Cushion, C. 2007. A National Health Service hospital's cardiac rehabilitation programme: a qualitative analysis of provision. Journal of Clinical Nursing. 16 (10), pp. 1908-1918. https://doi.org/10.1111/j.1365-2702.2007.01815.x
Inequalities in the training and implementation of cardiac rehabilitation in the United Kingdom
O'Driscoll, J. and Sharma, R. 2009. Inequalities in the training and implementation of cardiac rehabilitation in the United Kingdom. in: Bennington, E. (ed.) Horizons in World Cardiovascular Research Hauppauge, New York Nova Science Publishers.