Gestational Hypertension, Hypertensive Disorder of Pregnancy, Preeclampsia
Conditions
Keywords
Hypertensive Disorders of Pregnancy, Gestational Hypertension, Preeclampsia, Pregnancy, Endothelial Dysfunction, Endothelial Extracellular Vesicles, Extracellular Vesicles, Endothelial Activation, Biomarkers, Microvascular Function, Laser Doppler Flowmetry, Cardiovascular Risk
Brief summary
Hypertensive disorders of pregnancy are associated with endothelial dysfunction and increased maternal and fetal morbidity. Endothelial extracellular vesicles (EEVs) have emerged as promising biomarkers of endothelial activation; however, their relationship with blood pressure and endothelial function during pregnancy remains incompletely understood. This observational case-control study aims to compare circulating EEV concentrations between normotensive pregnant women and pregnant women with hypertensive disorders of pregnancy. The study will also investigate the associations between EEV levels, blood pressure, microvascular endothelial function assessed by laser Doppler flowmetry, and circulating biomarkers of endothelial activation. The findings may improve understanding of endothelial injury during pregnancy and support the development of non-invasive biomarkers for early detection and monitoring of hypertensive disorders of pregnancy.
Interventions
None listed
Sponsors
Josip Juraj Strossmayer University of Osijek
Osijek University Hospital
Study design
Observational model
CASE_CONTROL
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Pregnant women aged ≥18 years. * Singleton pregnancy. * Ability to provide written informed consent. * Normotensive pregnancy or diagnosis of gestational hypertension or preeclampsia according to current clinical guidelines. * Ability to comply with study procedures.
Exclusion criteria
* Chronic hypertension diagnosed before pregnancy. * Multiple pregnancy. * Pre-existing diabetes mellitus. * Chronic kidney disease. * Autoimmune disease. * Known cardiovascular disease. * Active infection or inflammatory disease. * Malignancy. * Inability or unwillingness to provide informed consent.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Plasma endothelial extracellular vesicle concentration | Baseline | Concentration of circulating endothelial extracellular vesicles quantified by flow cytometry following size-exclusion chromatography isolation. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Post-occlusive reactive hyperemia (PORH) | Baseline | Microvascular endothelium-dependent vasodilation assessed by laser Doppler flowmetry following 1-minute arterial occlusion. |
| Acetylcholine-induced vasodilation (AChID) | Baseline | Endothelium-dependent microvascular vasodilation assessed by acetylcholine iontophoresis and laser Doppler flowmetry. |
| Sodium nitroprusside-induced vasodilation (SNPID) | Baseline | Endothelium-independent microvascular vasodilation assessed by sodium nitroprusside iontophoresis and laser Doppler flowmetry. |
| VCAM-1 concentration | Baseline | Plasma vascular cell adhesion molecule-1 (VCAM-1) concentration measured as a marker of endothelial activation. |
| ICAM-1 concentration | Baseline | Plasma intercellular adhesion molecule-1 (ICAM-1) concentration measured as a marker of endothelial activation. |
| Endocan concentration | Baseline | Plasma endocan concentration measured as a marker of endothelial dysfunction. |
| von Willebrand factor (vWF) | Baseline | Plasma von Willebrand factor concentration measured as a marker of endothelial injury. |
| Matrix metalloproteinase-9 (MMP-9) | Baseline | Plasma MMP-9 concentration measured as a marker of vascular remodeling and endothelial dysfunction. |
Countries
Croatia
Contacts
CONTACTMartina Vulin, MD, PhD
CONTACTAna Stupin, MD, PhD
STUDY_CHAIRAna Stupin, MD, PhD
Faculty of Medicine Osijek, Josip Juraj Strossmayer of Osijek
Outcome results
None listed