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Preeclampsia (PE) is a pregnancy-related hypertensive disorder drive by an anti-angiogenic environment. Women with PE have 2-4 time higher risk of developing cardiovascular disease (CVD), although the specific mechanism relating these two conditions remains elusive. In non-pregnant patients with coronary disease, angiogenic profile proved to be an independent predictor of poor prognosis and is associated with a higher mortality rate. The investigators hypothesized that in PE, the antiangiogenic environment determines the degree of cardiac dysfunction and remodeling and the posterior cardiovascular risk.
Main objective: To determinie the relationship between antiangiogenic environment and cardioc dysfuntion and remodelin in women at risk and in established PE. M&M: placental dysfunction markers (angiogenic factors (PlGF) and anti-angiogenic factor (sFlt1) and cardiovascular risk variables (BMI, BP, arterial stiffness, copectin, proBNP, high-sensitivity troponin, carotid intima thickness and echocardiography parameters) would be evaluated in 280 patients at risk of PE according to first trimester screening and 100 controls. Additionally, cardiac dysfunction parameters would be evaluated in women with established PE (n=60) and common transcriptomic signatures between cardiovascular disease and preeclampsia would be investigated in placental samples from 10 PE and 10 controls. It will provide evidences to evaluate and characterize the association between angiogenic factors and cardiac dysfunction and remodeling in PE.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| High Risk of Preeclampsia | Women with a singleton pregnancies attending for prenatal care in the maternal and fetal Medicine Unit will be asked to participate if they meet the following criteria: 1)High risk for preeclampsia according to first trimester screening (maternal risk factors, blood preassure, PPAP-A, mean pulsatility index (PIm) of the uterine arteries (UtA) at 11.0 to 13.6 weeks of gestation (n=280). Women in this group will be subdivided in cases and controls according to the later development of preeclampsia:
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| |
| Patients with Preeclampsia | Women with a singleton pregnancies attending for prenatal care in the maternal and fetal Medicine Unit will be asked to participate if they develop PE. Inclusion criteria: Patients presented with clinical signs and symptoms of preeclampsia (N=60). |
| |
| Control group | Healthy pregnant women with at low risk PE screening at 11.0 to 13.6 weeks of gestation (n=100). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ecocardiographyc ultrasound | Diagnostic Test |
|
| Measure | Description | Time Frame |
|---|---|---|
| To prospectively assess both biochemical and biophysical markers of cardiovascular dysfunction in a cohort of patients with a risk of pe and in healthy pregnant women in the fisrt and third trimester of pregnancy. | - Cardiac dysfunction/remodeling in the first and third trimester of pregnancy and in 12 moths after delivery as defined by:
| 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| To determine the correlation among antiogenic (PlGF) and anti-angiogenic factors (sFlt1) in maternal serum and biochemical and imaging markers of cardiac dysfunction and remodeling in patients with established PE AND | Venous blood will be drawn, with informed consent, from the cubital vein without a tourniquet and using a 20-G needle into Vacutainer CPT | 9 months |
| Measure | Description | Time Frame |
|---|---|---|
| Determine cardiac dysfunction and metabolic status at 12 months after delivery and its correlation with cardiac and preeclampsia risk variables obtained during pregnancy | 12 months | |
| To investigate angiogenesis and cardiovascular related genes in placental samples of women with preeclampsia and controls by microarrays and PCR validation. |
Inclusion Criteria:
Exclusion Criteria:
Pregnant women
Pregnant women at high risk of \
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Elisa Llurba | Contact | +0034932919000 | ellurba@santpau.cat |
| Name | Affiliation | Role |
|---|---|---|
| Elisa Llurba | Institut de Recerca Hospital de la Santa Creu i Sant Pau | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospital de la Santa Creu i Sant Pau | Recruiting | Barcelona | 08025 | Spain |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40471220 | Derived | Ullmo J, Cruz-Lemini M, Bos-Real L, Padilla M, Coma-Barbara M, Martorell S, Mora J, Ordonez-Llanos J, Llurba E; AngioCor working group. Cardiovascular risk assessment in women at high risk for pre-eclampsia in first half of pregnancy. Ultrasound Obstet Gynecol. 2025 Jul;66(1):65-72. doi: 10.1002/uog.29247. Epub 2025 Jun 5. | |
| 34879854 |
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| ID | Term |
|---|---|
| D011225 | Pre-Eclampsia |
| D011248 | Pregnancy Complications |
| ID | Term |
|---|---|
| D046110 | Hypertension, Pregnancy-Induced |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
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| ID | Term |
|---|---|
| D006403 | Hematologic Tests |
| D059168 | Carotid Intima-Media Thickness |
| ID | Term |
|---|---|
| D019411 | Clinical Laboratory Techniques |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
| D008919 | Investigative Techniques |
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Blood samples, Placental samples, umbilical cord samples
|
|
Placenta will be collected at delivery time and tissue samples will be frozen in liquid N2 and fixed for histology and immunohistochemistry. |
| 1 month |
| Ullmo J, Cruz-Lemini M, Sanchez-Garcia O, Bos-Real L, Fernandez De La Llama P, Calero F, Dominguez-Gallardo C, Garrido-Gimenez C, Trilla C, Carreras-Costa F, Sionis A, Mora J, Garcia-Osuna A, Ordonez-Llanos J, Llurba E. Cardiac dysfunction and remodeling regulated by anti-angiogenic environment in patients with preeclampsia: the ANGIOCOR prospective cohort study protocol. BMC Pregnancy Childbirth. 2021 Dec 8;21(1):816. doi: 10.1186/s12884-021-04263-w. |
| D000092262 | Ultrasonography, Carotid Arteries |
| D014463 | Ultrasonography |
| D003952 | Diagnostic Imaging |
| D003935 | Diagnostic Techniques, Cardiovascular |
| D002320 | Cardiovascular Physiological Phenomena |
| D002943 | Circulatory and Respiratory Physiological Phenomena |