Individual artery wall layer dimensions indicate increased cardiovascular risk in previous severe preeclampsia -an investigation using non-invasive high-frequency ultrasound

Abstract

Background: Preeclampsia (PE) is associated with increased risk for cardiovascular disease later in life. Studies using gold standard of non-invasive estimation of atherosclerosis, the common carotid artery intima-media-thickness (CCA-IMT), have not indicated increased atherosclerosis in women with previous PE. That reason may be that with increasing age and degree of atherosclerosis the intima increases, while the media decreases.

Objectives: To assess whether the individual thickness of the CCA intima and media layers and calculation of intima/media (I/M) ratio indicate an increased cardiovascular risk in women with previous severe PE.

Method: Arterial intima- and media tthicknesses were obtained by non-invasive high-frequency ultrasound (22MHz) in 42 women with previous severe PE and 44 women with previous normal pregnancies.

Results: Women with previous severe PE had a thicker mean CCA intima and a higher I/M ratio, compared to women with previous normal pregnancies (both p<0.0001). In ROC curve analysis, intima thickness and I/M ratio discriminated strongly with regard to previous severe PE.

Conclusion: The method using individual estimation of the CCA intima and media layers and calculating the I/M ratio, clearly showed an increased degree of atherosclerosis in women with previous severe PE. This method might become a clinically useful tool to stratify cardiovascular risk, enabling early intervention and hopefully reduce their long-term cardiovascular risk.