Abnormal endothelium-dependent microvascular reactivity in recently preeclamptic women.
OBJECTIVE
To assess endothelial function at the level of skin microvasculature, using iontophoretic administration of acetylcholine (endothelium-dependent vasodilator) and sodium nitroprusside (endothelium-independent vasodilator), in women who recently had a preeclamptic pregnancy.


METHODS
Microvascular skin reactivity was assessed by laser Doppler perfusion monitoring and iontophoresis of acetylcholine (ACh) and sodium nitroprusside (SNP) in 25 women with a history of early onset preeclampsia and 23 women with previous uncomplicated pregnancies, all of whom were between 3 and 11 months postpartum.


RESULTS
Mean (+/- standard error of the mean) ACh-mediated vasodilatation, expressed as a percentage increase in flux, was higher in women who recently had a preeclampsia than in controls (535 +/- 46% versus 314 +/- 29%, P < .001). In contrast, SNP-mediated vasodilatation was not significantly different (560 +/- 71% versus 483 +/- 69%, P = .4) in both groups. Linear regression analysis revealed that the difference in ACh-mediated vasodilatation was explained by preeclampsia (P = .004), whereas vascular risk factors such as maternal age, diastolic blood pressure, and family history of premature cardiovascular diseases had no significant effect.


CONCLUSIONS
The increased ACh-mediated vasodilatation in the microcirculation of recently preeclamptic women indicates abnormal endothelial function. Furthermore, it may represent a compensatory response to an impaired vasodilatory response of the macrocirculation, thereby supporting the hypothesis of an underlying (micro)angiopathy.
Blaauw
Judith
J
Department of Obstetrics and Gynecology, Groningen University Medical Centre, Groningen, The Netherlands.
Graaff
Reindert
R
van Pampus
Maria G
MG
van Doormaal
Jasper J
JJ
Smit
Andries J
AJ
Rakhorst
Gerhard
G
Aarnoudse
Jan G
JG
D000109:Acetylcholine / Q000494:pharmacology; D000328:Adult; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007478:Iontophoresis; D017078:Laser-Doppler Flowmetry; D008833:Microcirculation / Q000503:physiopathology; D009599:Nitroprusside / Q000494:pharmacology; D011225:Pre-Eclampsia / Q000503:physiopathology*; D011247:Pregnancy; D012867:Skin / Q000098:blood supply*; D014664:Vasodilation / Q000187:drug effects*; D014665:Vasodilator Agents / Q000494:pharmacology
D014665:Vasodilator Agents; D009599:Nitroprusside; D000109:Acetylcholine