title: Cardiovascular and thrombogenic risk of decidual vasculopathy in preeclampsia.
abstract: OBJECTIVE
  Women with a history of preeclampsia (PE) have an increased prevalence of cardiometabolic, cardiovascular, and prothrombotic risk factors. Remotely, these women are at increased risk of developing cardiovascular and thrombotic disease. Decidual vasculopathy (DV) describes vascular lesions in the maternal spiral arteries of the uterus, which are found in approximately 40-60% of women with PE. DV is thought to be related to atherosclerosis because of their morphological similarity. The aim of this study was to investigate the association of cardiovascular and thrombogenic risk factors with DV in women with a history of PE.
  
  
  METHODS
  We retrospectively analyzed the cardiovascular and thrombogenic risk of women with a history of PE, comparing cases with DV (n = 95) with cases without the lesions (n = 81) 7 months after the index pregnancy. Data from a cohort of patients with a history of PE were matched with records from our pathology database.
  
  
  RESULTS
  The DV group showed higher diastolic blood pressure (73 vs 70 mm Hg, P = .031), lower left ventricular stroke volume (71 vs 76 mL, P = .032), higher total peripheral vascular resistance (1546 vs 1385, P = .009), and a higher percentage of low plasma volume (34% vs 19%, P = .030). DV did not relate to other cardiovascular parameters, urinary protein, body mass index, lipid or glucose metabolism parameters, or thrombophilia.
  
  
  CONCLUSIONS
  In this study, in women with a history of PE, cases with DV had increased cardiovascular risk, exhibiting circulatory alterations, suggesting reduced venous reserves and elevated arterial tone, without metabolic or thrombophilic disturbances.
authors.affiliation: Department of Obstetrics and Gynecology, Radboud university medical center, Nijmegen, The Netherlands. Electronic address: droima.stevens@radboudumc.nl.
authors.forename: Droïma U
authors.initials: DU
authors.lastname: Stevens
authors.affiliation: GROW, School for Oncology and Developmental Biology, Department of Obstetrics and Gynecology, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Salwan
authors.initials: S
authors.lastname: Al-Nasiry
authors.affiliation: Department of Obstetrics and Gynecology, Radboud university medical center, Nijmegen, The Netherlands.
authors.forename: Marcela M
authors.initials: MM
authors.lastname: Fajta
authors.affiliation: Department of Pathology, Radboud university medical center, Nijmegen, The Netherlands.
authors.forename: Johan
authors.initials: J
authors.lastname: Bulten
authors.affiliation: Department of Cardiology, Radboud university medical center, Nijmegen, The Netherlands.
authors.forename: Arie P
authors.initials: AP
authors.lastname: van Dijk
authors.affiliation: Department of Cardiology, Radboud university medical center, Nijmegen, The Netherlands.
authors.forename: Maureen J
authors.initials: MJ
authors.lastname: van der Vlugt
authors.affiliation: Department of Nuclear Medicine, Radboud university medical center, Nijmegen, The Netherlands.
authors.forename: Wim J
authors.initials: WJ
authors.lastname: Oyen
authors.affiliation: Department of Obstetrics and Gynecology, Radboud university medical center, Nijmegen, The Netherlands.
authors.forename: John M
authors.initials: JM
authors.lastname: van Vugt
authors.affiliation: GROW, School for Oncology and Developmental Biology, Department of Obstetrics and Gynecology, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Marc E
authors.initials: ME
authors.lastname: Spaanderman
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000503:physiopathology; D015331:Cohort Studies; D003656:Decidua / Q000098:blood supply* / Q000503:physiopathology; D004452:Echocardiography; D005260:Female; D006801:Humans; D010920:Placenta / Q000473:pathology*; D011225:Pre-Eclampsia / Q000473:pathology* / Q000503:physiopathology; D011247:Pregnancy; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D019851:Thrombophilia / Q000175:diagnosis*
keywords: acute atherosis; cardiovascular risk; decidual vasculopathy; preeclampsia