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Published in: BMC Pregnancy and Childbirth 1/2014

Open Access 01-12-2014 | Research article

Carotid artery elasticity decreases during pregnancy - the Cardiovascular Risk in Young Finns study

Authors: Henna Kärkkäinen, Heli Saarelainen, Pirjo Valtonen, Tiina Laitinen, Olli T Raitakari, Markus Juonala, Mika Kähönen, Nina Hutri-Kähönen, Seppo Heinonen, Tomi Laitinen

Published in: BMC Pregnancy and Childbirth | Issue 1/2014

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Abstract

Background

The aims were to evaluate the effect of pregnancy on carotid artery elasticity and determine the associations between maternal lipids, endothelial function and arterial elasticity during pregnancy.

Methods

We examined 99 pregnant and 99 matched non-pregnant control women as part of a population-based prospective cohort study. Carotid artery elasticity indexes; carotid artery distensibility (CAD), Young’s elastic modulus (YEM) and stiffness index (SI) as well as brachial artery flow-mediated dilation (FMD) were assessed using ultrasound; serum lipid levels were also determined.

Results

SI was 57% and YEM 75% higher and CAD 36% lower in the third trimester group than the corresponding values in the first trimester group. Serum cholesterol and triglyceride levels were significantly higher in women at the end of the pregnancy than at the beginning of pregnancy (P < 0.001) and in controls (P < 0.001). In multivariate analysis, gestational age was the only independent correlate of arterial elasticity in pregnant women. In controls, age (P ≤ 0.001) and common carotid diameter (P = 0.001-0.029) were associated with SI, YEM and CAD.

Conclusions

The present study revealed that carotid artery elasticity declined towards the end of the pregnancy; this neither is straight correlating with maternal hyperlipidemia or the diameter of the carotid artery nor is it associated with changes in endothelial function.
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Literature
1.
go back to reference Khalil A, Jauniaux E, Cooper D, Harrington K: Pulse wave analysis in normal pregnancy: a prospective longitudinal study. PLoS One. 2009, 4 (7): e6134-10.1371/journal.pone.0006134.CrossRefPubMedPubMedCentral Khalil A, Jauniaux E, Cooper D, Harrington K: Pulse wave analysis in normal pregnancy: a prospective longitudinal study. PLoS One. 2009, 4 (7): e6134-10.1371/journal.pone.0006134.CrossRefPubMedPubMedCentral
2.
go back to reference Macedo ML, Luminoso D, Savvidou MD, McEniery CM, Nicolaides KH: Maternal wave reflections and arterial stiffness in normal pregnancy as assessed by applanation tonometry. Hypertension. 2008, 51 (4): 1047-1051. 10.1161/HYPERTENSIONAHA.107.106062.CrossRefPubMed Macedo ML, Luminoso D, Savvidou MD, McEniery CM, Nicolaides KH: Maternal wave reflections and arterial stiffness in normal pregnancy as assessed by applanation tonometry. Hypertension. 2008, 51 (4): 1047-1051. 10.1161/HYPERTENSIONAHA.107.106062.CrossRefPubMed
3.
go back to reference Robb AO, Mills NL, Din JN, Smith IB, Paterson F, Newby DE, Denison FC: Influence of the menstrual cycle, pregnancy, and preeclampsia on arterial stiffness. Hypertension. 2009, 53 (6): 952-958. 10.1161/HYPERTENSIONAHA.109.130898.CrossRefPubMed Robb AO, Mills NL, Din JN, Smith IB, Paterson F, Newby DE, Denison FC: Influence of the menstrual cycle, pregnancy, and preeclampsia on arterial stiffness. Hypertension. 2009, 53 (6): 952-958. 10.1161/HYPERTENSIONAHA.109.130898.CrossRefPubMed
4.
go back to reference Karkkainen H, Heiskanen N, Saarelainen H, Valtonen P, Lyyra-Laitinen T, Laitinen T, Vanninen E, Heinonen S: Ambulatory arterial stiffness index is unchanged in uncomplicated third-trimester singleton and twin pregnancies. Acta Obstet Gynecol Scand. 2011, 90 (5): 516-523. 10.1111/j.1600-0412.2011.01101.x.CrossRefPubMed Karkkainen H, Heiskanen N, Saarelainen H, Valtonen P, Lyyra-Laitinen T, Laitinen T, Vanninen E, Heinonen S: Ambulatory arterial stiffness index is unchanged in uncomplicated third-trimester singleton and twin pregnancies. Acta Obstet Gynecol Scand. 2011, 90 (5): 516-523. 10.1111/j.1600-0412.2011.01101.x.CrossRefPubMed
5.
go back to reference Ronnback M, Lampinen K, Groop PH, Kaaja R: Pulse wave reflection in currently and previously preeclamptic women. Hypertens Pregnancy. 2005, 24 (2): 171-180. 10.1081/PRG-200059871.CrossRefPubMed Ronnback M, Lampinen K, Groop PH, Kaaja R: Pulse wave reflection in currently and previously preeclamptic women. Hypertens Pregnancy. 2005, 24 (2): 171-180. 10.1081/PRG-200059871.CrossRefPubMed
6.
go back to reference Tihtonen KM, Koobi T, Uotila JT: Arterial stiffness in preeclamptic and chronic hypertensive pregnancies. Eur J Obstet Gynecol Reprod Biol. 2006, 128 (1–2): 180-186.CrossRefPubMed Tihtonen KM, Koobi T, Uotila JT: Arterial stiffness in preeclamptic and chronic hypertensive pregnancies. Eur J Obstet Gynecol Reprod Biol. 2006, 128 (1–2): 180-186.CrossRefPubMed
7.
go back to reference Visontai Z, Lenard Z, Studinger P, Rigo J, Kollai M: Impaired baroreflex function during pregnancy is associated with stiffening of the carotid artery. Ultrasound Obstet Gynecol. 2002, 20 (4): 364-369. 10.1046/j.1469-0705.2002.00820.x.CrossRefPubMed Visontai Z, Lenard Z, Studinger P, Rigo J, Kollai M: Impaired baroreflex function during pregnancy is associated with stiffening of the carotid artery. Ultrasound Obstet Gynecol. 2002, 20 (4): 364-369. 10.1046/j.1469-0705.2002.00820.x.CrossRefPubMed
8.
go back to reference Mersich B, Rigo J, Besenyei C, Lenard Z, Studinger P, Kollai M: Opposite changes in carotid versus aortic stiffness during healthy human pregnancy. Clin Sci (Lond). 2005, 109 (1): 103-107. 10.1042/CS20040352.CrossRef Mersich B, Rigo J, Besenyei C, Lenard Z, Studinger P, Kollai M: Opposite changes in carotid versus aortic stiffness during healthy human pregnancy. Clin Sci (Lond). 2005, 109 (1): 103-107. 10.1042/CS20040352.CrossRef
9.
go back to reference Brizzi P, Tonolo G, Esposito F, Puddu L, Dessole S, Maioli M, Milia S: Lipoprotein metabolism during normal pregnancy. Am J Obstet Gynecol. 1999, 181 (2): 430-434. 10.1016/S0002-9378(99)70574-0.CrossRefPubMed Brizzi P, Tonolo G, Esposito F, Puddu L, Dessole S, Maioli M, Milia S: Lipoprotein metabolism during normal pregnancy. Am J Obstet Gynecol. 1999, 181 (2): 430-434. 10.1016/S0002-9378(99)70574-0.CrossRefPubMed
10.
go back to reference Mazurkiewicz JC, Watts GF, Warburton FG, Slavin BM, Lowy C, Koukkou E: Serum lipids, lipoproteins and apolipoproteins in pregnant non-diabetic patients. J Clin Pathol. 1994, 47 (8): 728-731. 10.1136/jcp.47.8.728.CrossRefPubMedPubMedCentral Mazurkiewicz JC, Watts GF, Warburton FG, Slavin BM, Lowy C, Koukkou E: Serum lipids, lipoproteins and apolipoproteins in pregnant non-diabetic patients. J Clin Pathol. 1994, 47 (8): 728-731. 10.1136/jcp.47.8.728.CrossRefPubMedPubMedCentral
11.
go back to reference Saarelainen H, Laitinen T, Raitakari OT, Juonala M, Heiskanen N, Lyyra-Laitinen T, Viikari JS, Vanninen E, Heinonen S: Pregnancy-related hyperlipidemia and endothelial function in healthy women. Circ J. 2006, 70 (6): 768-772. 10.1253/circj.70.768.CrossRefPubMed Saarelainen H, Laitinen T, Raitakari OT, Juonala M, Heiskanen N, Lyyra-Laitinen T, Viikari JS, Vanninen E, Heinonen S: Pregnancy-related hyperlipidemia and endothelial function in healthy women. Circ J. 2006, 70 (6): 768-772. 10.1253/circj.70.768.CrossRefPubMed
12.
go back to reference Herrera E, Ortega-Senovilla H: Disturbances in lipid metabolism in diabetic pregnancy - Are these the cause of the problem?. Best Pract Res Clin Endocrinol Metab. 2010, 24 (4): 515-525. 10.1016/j.beem.2010.05.006.CrossRefPubMed Herrera E, Ortega-Senovilla H: Disturbances in lipid metabolism in diabetic pregnancy - Are these the cause of the problem?. Best Pract Res Clin Endocrinol Metab. 2010, 24 (4): 515-525. 10.1016/j.beem.2010.05.006.CrossRefPubMed
13.
go back to reference Juonala M, Viikari JS, Hutri-Kahonen N, Pietikainen M, Jokinen E, Taittonen L, Marniemi J, Ronnemaa T, Raitakari OT: The 21-year follow-up of the Cardiovascular Risk in Young Finns study: risk factor levels, secular trends and east-west difference. J Intern Med. 2004, 255 (4): 457-468. 10.1111/j.1365-2796.2004.01308.x.CrossRefPubMed Juonala M, Viikari JS, Hutri-Kahonen N, Pietikainen M, Jokinen E, Taittonen L, Marniemi J, Ronnemaa T, Raitakari OT: The 21-year follow-up of the Cardiovascular Risk in Young Finns study: risk factor levels, secular trends and east-west difference. J Intern Med. 2004, 255 (4): 457-468. 10.1111/j.1365-2796.2004.01308.x.CrossRefPubMed
14.
go back to reference Raitakari OT, Juonala M, Kahonen M, Taittonen L, Laitinen T, Maki-Torkko N, Jarvisalo MJ, Uhari M, Jokinen E, Ronnemaa T, Akerblom HK, Viikari JS: Cardiovascular risk factors in childhood and carotid artery intima-media thickness in adulthood: the Cardiovascular Risk in Young Finns Study. JAMA. 2003, 290 (17): 2277-2283. 10.1001/jama.290.17.2277.CrossRefPubMed Raitakari OT, Juonala M, Kahonen M, Taittonen L, Laitinen T, Maki-Torkko N, Jarvisalo MJ, Uhari M, Jokinen E, Ronnemaa T, Akerblom HK, Viikari JS: Cardiovascular risk factors in childhood and carotid artery intima-media thickness in adulthood: the Cardiovascular Risk in Young Finns Study. JAMA. 2003, 290 (17): 2277-2283. 10.1001/jama.290.17.2277.CrossRefPubMed
15.
go back to reference Juonala M, Jarvisalo MJ, Maki-Torkko N, Kahonen M, Viikari JS, Raitakari OT: Risk factors identified in childhood and decreased carotid artery elasticity in adulthood: the Cardiovascular risk in Young Finns study. Circulation. 2005, 112 (10): 1486-1493. 10.1161/CIRCULATIONAHA.104.502161.CrossRefPubMed Juonala M, Jarvisalo MJ, Maki-Torkko N, Kahonen M, Viikari JS, Raitakari OT: Risk factors identified in childhood and decreased carotid artery elasticity in adulthood: the Cardiovascular risk in Young Finns study. Circulation. 2005, 112 (10): 1486-1493. 10.1161/CIRCULATIONAHA.104.502161.CrossRefPubMed
16.
go back to reference Riley WA, Barnes RW, Evans GW, Burke GL: Ultrasonic measurement of the elastic modulus of the common carotid artery: the atherosclerosis risk in communities (ARIC) Study. Stroke. 1992, 23 (7): 952-956. 10.1161/01.STR.23.7.952.CrossRefPubMed Riley WA, Barnes RW, Evans GW, Burke GL: Ultrasonic measurement of the elastic modulus of the common carotid artery: the atherosclerosis risk in communities (ARIC) Study. Stroke. 1992, 23 (7): 952-956. 10.1161/01.STR.23.7.952.CrossRefPubMed
17.
go back to reference Hirai T, Sasayama S, Kawasaki T, Yagi S: Stiffness of systemic arteries in patients with myocardial infarction: a noninvasive method to predict severity of coronary atherosclerosis. Circulation. 1989, 80 (1): 78-86. 10.1161/01.CIR.80.1.78.CrossRefPubMed Hirai T, Sasayama S, Kawasaki T, Yagi S: Stiffness of systemic arteries in patients with myocardial infarction: a noninvasive method to predict severity of coronary atherosclerosis. Circulation. 1989, 80 (1): 78-86. 10.1161/01.CIR.80.1.78.CrossRefPubMed
18.
go back to reference Juonala M, Viikari JS, Laitinen T, Marniemi J, Helenius H, Ronnemaa T, Raitakari OT: Interrelations between brachial endothelial function and carotid intima-media thickness in young adults: the Cardiovascular Risk in Young Finns study. Circulation. 2004, 110 (18): 2918-2923. 10.1161/01.CIR.0000147540.88559.00.CrossRefPubMed Juonala M, Viikari JS, Laitinen T, Marniemi J, Helenius H, Ronnemaa T, Raitakari OT: Interrelations between brachial endothelial function and carotid intima-media thickness in young adults: the Cardiovascular Risk in Young Finns study. Circulation. 2004, 110 (18): 2918-2923. 10.1161/01.CIR.0000147540.88559.00.CrossRefPubMed
19.
go back to reference Urbina EM, Srinivasan SR, Kieltyka RL, Tang R, Bond MG, Chen W, Berenson GS: Correlates of carotid artery stiffness in young adults: the Bogalusa Heart Study. Atherosclerosis. 2004, 176 (1): 157-164. 10.1016/j.atherosclerosis.2004.04.023.CrossRefPubMed Urbina EM, Srinivasan SR, Kieltyka RL, Tang R, Bond MG, Chen W, Berenson GS: Correlates of carotid artery stiffness in young adults: the Bogalusa Heart Study. Atherosclerosis. 2004, 176 (1): 157-164. 10.1016/j.atherosclerosis.2004.04.023.CrossRefPubMed
20.
go back to reference Scott CA, Bewley S, Rudd A, Spark P, Kurinczuk JJ, Brocklehurst P, Knight M: Incidence, risk factors, management, and outcomes of stroke in pregnancy. Obstet Gynecol. 2012, 120 (2 Pt 1): 318-324.CrossRefPubMed Scott CA, Bewley S, Rudd A, Spark P, Kurinczuk JJ, Brocklehurst P, Knight M: Incidence, risk factors, management, and outcomes of stroke in pregnancy. Obstet Gynecol. 2012, 120 (2 Pt 1): 318-324.CrossRefPubMed
21.
go back to reference Kuklina EV, Tong X, Bansil P, George MG, Callaghan WM: Trends in pregnancy hospitalizations that included a stroke in the United States from 1994 to 2007: reasons for concern?. Stroke. 2011, 42 (9): 2564-2570. 10.1161/STROKEAHA.110.610592.CrossRefPubMed Kuklina EV, Tong X, Bansil P, George MG, Callaghan WM: Trends in pregnancy hospitalizations that included a stroke in the United States from 1994 to 2007: reasons for concern?. Stroke. 2011, 42 (9): 2564-2570. 10.1161/STROKEAHA.110.610592.CrossRefPubMed
22.
go back to reference Koskinen J, Kahonen M, Viikari JS, Taittonen L, Laitinen T, Ronnemaa T, Lehtimaki T, Hutri-Kahonen N, Pietikainen M, Jokinen E, Helenius H, Mattsson N, Raitakari OT, Juonala M: Conventional cardiovascular risk factors and metabolic syndrome in predicting carotid intima-media thickness progression in young adults: the Cardiovascular Risk in Young Finns study. Circulation. 2009, 120 (3): 229-236. 10.1161/CIRCULATIONAHA.108.845065.CrossRefPubMed Koskinen J, Kahonen M, Viikari JS, Taittonen L, Laitinen T, Ronnemaa T, Lehtimaki T, Hutri-Kahonen N, Pietikainen M, Jokinen E, Helenius H, Mattsson N, Raitakari OT, Juonala M: Conventional cardiovascular risk factors and metabolic syndrome in predicting carotid intima-media thickness progression in young adults: the Cardiovascular Risk in Young Finns study. Circulation. 2009, 120 (3): 229-236. 10.1161/CIRCULATIONAHA.108.845065.CrossRefPubMed
23.
go back to reference Hu S, Leonard A, Seifalian A, Hardiman P: Vascular dysfunction during pregnancy in women with polycystic ovary syndrome. Hum Reprod. 2007, 22 (6): 1532-1539. 10.1093/humrep/dem028.CrossRefPubMed Hu S, Leonard A, Seifalian A, Hardiman P: Vascular dysfunction during pregnancy in women with polycystic ovary syndrome. Hum Reprod. 2007, 22 (6): 1532-1539. 10.1093/humrep/dem028.CrossRefPubMed
24.
go back to reference Spaanderman ME, Willekes C, Hoeks AP, Ekhart TH, Peeters LL: The effect of pregnancy on the compliance of large arteries and veins in healthy parous control subjects and women with a history of preeclampsia. Am J Obstet Gynecol. 2000, 183 (5): 1278-1286. 10.1067/mob.2000.106750.CrossRefPubMed Spaanderman ME, Willekes C, Hoeks AP, Ekhart TH, Peeters LL: The effect of pregnancy on the compliance of large arteries and veins in healthy parous control subjects and women with a history of preeclampsia. Am J Obstet Gynecol. 2000, 183 (5): 1278-1286. 10.1067/mob.2000.106750.CrossRefPubMed
25.
go back to reference Weissgerber TL, Davies GA, Tschakovsky ME: Brachial artery flow-mediated dilation is not affected by pregnancy or regular exercise participation. Clin Sci (Lond). 2011, 121 (8): 355-365. 10.1042/CS20110008.CrossRef Weissgerber TL, Davies GA, Tschakovsky ME: Brachial artery flow-mediated dilation is not affected by pregnancy or regular exercise participation. Clin Sci (Lond). 2011, 121 (8): 355-365. 10.1042/CS20110008.CrossRef
26.
go back to reference Yuan LJ, Xue D, Duan YY, Cao TS, Zhou N: Maternal carotid remodeling and increased carotid arterial stiffness in normal late-gestational pregnancy as assessed by radio-frequency ultrasound technique. BMC Preg Childbirth. 2013, 13 (1): 122-10.1186/1471-2393-13-122.CrossRef Yuan LJ, Xue D, Duan YY, Cao TS, Zhou N: Maternal carotid remodeling and increased carotid arterial stiffness in normal late-gestational pregnancy as assessed by radio-frequency ultrasound technique. BMC Preg Childbirth. 2013, 13 (1): 122-10.1186/1471-2393-13-122.CrossRef
Metadata
Title
Carotid artery elasticity decreases during pregnancy - the Cardiovascular Risk in Young Finns study
Authors
Henna Kärkkäinen
Heli Saarelainen
Pirjo Valtonen
Tiina Laitinen
Olli T Raitakari
Markus Juonala
Mika Kähönen
Nina Hutri-Kähönen
Seppo Heinonen
Tomi Laitinen
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2014
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/1471-2393-14-98

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