title: Patterns of maternal vascular remodeling and responsiveness in early- versus late-onset preeclampsia.
abstract: OBJECTIVE
  We sought to assess vascular structure and function in early- and late-onset preeclampsia (PE) at the time of diagnosis.
  
  
  METHODS
  We evaluated 100 PE cases subdivided into 50 early- and 50 late-onset cases according to gestational age at onset (</>34 weeks), and 100 controls paired by maternal age and gestational age at scan with cases. Carotid intima-media thickness (IMT), distensibility, and circumferential wall stress together with inferior vena cava (IVC) collapsibility were assessed by ultrasound.
  
  
  RESULTS
  Early PE was characterized by increased carotid IMT diameters, and arterial stiffness with no significant changes in IVC parameters as compared to normotensive pregnancies. Late PE was characterized by significantly increased carotid IMT and lumen diameters as compared to controls while arterial stiffness, as expressed by distensibility, did not provide pronounced changes. A significant decrease of IVC collapsibility index was also observed in late PE as compared to controls.
  
  
  CONCLUSIONS
  The current data suggest that distinct vascular adaptations in early and late PE could reflect different pathophysiologic mechanisms. Future studies are warranted to further assess the complex etiologies and clinical expressions of the 2 entities.
authors.affiliation: Department of Maternal-Fetal Medicine, Instituto Clinic de Ginecología, Obstetricia y Neonatología, Hospital Clinic, Universitat de Barcelona, the Fetal and Perinatal Medicine Research Group, Institut d'Investigacions Biomediques August Pi i Sunyer, and the Centro de Investigación Biomédica en Red de Enfermedades Raras, Barcelona, Spain.
authors.forename: Iosifina
authors.initials: I
authors.lastname: Stergiotou
authors.forename: Fatima
authors.initials: F
authors.lastname: Crispi
authors.forename: Brenda
authors.initials: B
authors.lastname: Valenzuela-Alcaraz
authors.forename: Bart
authors.initials: B
authors.lastname: Bijnens
authors.forename: Eduard
authors.initials: E
authors.lastname: Gratacos
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001794:Blood Pressure / Q000502:physiology*; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011225:Pre-Eclampsia / Q000175:diagnosis* / Q000503:physiopathology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000503:physiopathology*; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D016216:Ultrasonography, Prenatal / Q000379:methods; D014682:Vena Cava, Inferior / Q000503:physiopathology*
keywords: carotid intima-media thickness; circumferential wall stress; distensibility; inferior vena cava collapsibility; preeclampsia