title: The use of pulse wave velocity in predicting pre-eclampsia in high-risk women.
abstract: In this study, we evaluated the diagnostic utility of pulse wave velocity (PWV) alone or in combination with other diagnostic markers in predicting pre-eclampsia (PE) in high-risk women. Pregnant women at high risk for PE were recruited between 22 and 26 weeks of gestation and were assessed for (a) PWV, (b) serum levels of the placental soluble fms-like tyrosine kinase 1 (sFlt-1) protein and uric acid and (c) 24-h urinary protein and calcium excretion. Sensitivities and specificities were derived from receiver operating characteristic curves. Of 118 women recruited, 11 and 10 women developed early-onset PE (<34 weeks) and late-onset PE (≥34 weeks), respectively. Of the five diagnostic markers tested, PWV showed the highest detection rate for all cases (21) of PE (81%) and for early-onset PE (82%) at a fixed 10% false-positive rate (FPR), and when combined with sFlt-1, these figures increased to 90% and 92%, respectively. Despite the reduced ability of PWV to predict late-onset PE (detection rate 20%), the combination of PWV with sFlt-1 achieved a detection rate of 50% at a fixed 10% FPR. A suggested cutoff value of 9 m/s for PWV resulted in optimal sensitivity (91%) and specificity (86%) for predicting early-onset PE. This study is the first to show that PWV may be a potentially promising predictor of early-onset PE in women at high risk for PE. The combination of PWV with sFlt-1 may further improve the screening efficacy for predicting PE.
authors.affiliation: Department of Nephrology, University Hospital of Heraklion, Heraklion, Crete, Greece.
authors.forename: Irene
authors.initials: I
authors.lastname: Katsipi
authors.affiliation: Department of Nephrology, University Hospital of Heraklion, Heraklion, Crete, Greece.
authors.forename: Kostas
authors.initials: K
authors.lastname: Stylianou
authors.affiliation: Department of Nephrology, University Hospital of Heraklion, Heraklion, Crete, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Petrakis
authors.affiliation: Department of Nephrology, University Hospital of Heraklion, Heraklion, Crete, Greece.
authors.forename: Andrew
authors.initials: A
authors.lastname: Passam
authors.affiliation: Department of Nephrology, University Hospital of Heraklion, Heraklion, Crete, Greece.
authors.forename: Eleftheria
authors.initials: E
authors.lastname: Vardaki
authors.affiliation: Department of Cardiology, University Hospital of Heraklion, Heraklion, Crete, Greece.
authors.forename: Fragkiskos
authors.initials: F
authors.lastname: Parthenakis
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Heraklion, Crete, Greece.
authors.forename: Antonios
authors.initials: A
authors.lastname: Makrygiannakis
authors.affiliation: Department of Nephrology, University Hospital of Heraklion, Heraklion, Crete, Greece.
authors.forename: Eugene
authors.initials: E
authors.lastname: Daphnis
authors.affiliation: Department of Nephrology, General Hospital of Chios, Chios, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Kyriazis
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers; D002118:Calcium / Q000652:urine; D005260:Female; D006801:Humans; D011225:Pre-Eclampsia / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011507:Proteinuria / Q000652:urine; D063177:Pulse Wave Analysis / Q000379:methods*; D012016:Reference Values; D012306:Risk; D014527:Uric Acid / Q000097:blood; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood; D055815:Young Adult
chemical_list: D015415:Biomarkers; D014527:Uric Acid; C501162:FLT1 protein, human; D040281:Vascular Endothelial Growth Factor Receptor-1; D002118:Calcium