Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 11 de 11
Filter
Add more filters










Publication year range
1.
Am J Obstet Gynecol ; 183(6): 1495-8, 2000 Dec.
Article in English | MEDLINE | ID: mdl-11120517

ABSTRACT

OBJECTIVE: Syndecan 1 is a cell surface heparan sulfate proteoglycan that binds growth factors and antithrombin III. The objective of this study was to examine whether placental expression of syndecan 1 in preeclampsia differs from that in normal pregnancy and whether gestational age and fetal growth affect syndecan 1 expression. STUDY DESIGN: An immunohistochemical analysis of 30 placentas of women with severe preeclampsia and 15 placentas of women without preeclampsia was performed with the monoclonal anti-syndecan 1 antibody B-B4. RESULTS: In 47% of preeclamptic placentas the immunoreactivity with antibody B-B4 was faint or absent, whereas 93% of the normal placentas exhibited strong immunoreactivity. The reduction in placental expression of syndecan 1 in preeclampsia was not associated with gestational age or impaired fetal growth. CONCLUSION: The expression of syndecan 1 on the chorionic villi is reduced in preeclampsia irrespective of gestational age or fetal growth.


Subject(s)
Membrane Glycoproteins/metabolism , Placenta/metabolism , Pre-Eclampsia/metabolism , Proteoglycans/metabolism , Antibodies, Monoclonal , Chorionic Villi/metabolism , Female , Humans , Immunohistochemistry/methods , Pregnancy , Reference Values , Syndecan-1 , Syndecans
2.
Cancer ; 88(9): 2149-53, 2000 May 01.
Article in English | MEDLINE | ID: mdl-10813728

ABSTRACT

BACKGROUND: Paclitaxel, which has been reported to be effective in treating metastatic breast carcinoma and advanced ovarian carcinoma, has been associated with cardiac side effects. Therefore, the effect of paclitaxel on cardiovascular autonomic regulation was studied. METHODS: Twenty-four-hour ambulatory electrocardiogram measurements were recorded twice from 14 women with breast or ovarian carcinoma: once before paclitaxel treatment and once on the day after the second chemotherapy course. Heart rate variability (HRV) was assessed with spectral analysis. For the frequency domain analysis, HRV was assessed in the very low (0.005-0.040 hertz [Hz]), low (0.040-0.150 Hz), and high frequency (0.150-0.400 Hz) spectral components. RESULTS: The ratio between low frequency and high frequency HRV decreased (daytime values of 2.7% [standard deviation (SD) 1.6] vs. 1.7% [SD 0.91; P = 0.0098) after 2 courses of paclitaxel. The circadian fluctuation of HRV also decreased in all studied frequency components. CONCLUSIONS: The observed changes in spectral characteristics suggest that autonomic modulation of the heart rate is impaired after paclitaxel therapy. However, from these data it is not clear whether the observed changes are permanent or whether autonomic cardiac function returns to normal some time after treatment. Further studies are needed to examine whether these indices based on HRV can be used to detect those patients at risk for cardiac side effects during chemotherapy.


Subject(s)
Antineoplastic Agents, Phytogenic/adverse effects , Autonomic Nervous System/drug effects , Heart Conduction System/drug effects , Heart Rate/drug effects , Paclitaxel/adverse effects , Adult , Aged , Analysis of Variance , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/drug therapy , Carcinoma/drug therapy , Carcinoma/secondary , Circadian Rhythm , Electrocardiography, Ambulatory/drug effects , Female , Follow-Up Studies , Humans , Middle Aged , Ovarian Neoplasms/drug therapy , Risk Factors , Signal Processing, Computer-Assisted
3.
Br J Obstet Gynaecol ; 106(3): 238-43, 1999 Mar.
Article in English | MEDLINE | ID: mdl-10426643

ABSTRACT

OBJECTIVE: To study the acute effects of tocolytic treatment with intravenous ritodrine on cardiovascular autonomic regulation. DESIGN: Validated methods to assess cardiovascular autonomic nervous function-heart rate and blood pressure variability and vagal cardiac baroreflex sensitivity-were measured before and during ritodrine infusion. SETTING: Turku University Central Hospital, Turku, Finland. SAMPLE: Twelve pregnant women admitted to hospital for threatened preterm labour. METHODS: Electrocardiogram and continuous noninvasive finger blood pressure signals were recorded in each woman, resting in a supine position. Autoregressive spectrum analysis was used to quantify short term heart rate and blood pressure variability. Vagal cardiac baroreflex sensitivity was measured as the bradycardia response to an intravenous bolus injection of phenylephrine. MAIN OUTCOME MEASURES: Vagal cardiac baroreflex sensitivity and spectrum analysis indices of short term heart rate and blood pressure variability. RESULTS: Ritodrine significantly decreased vagal cardiac baroreflex sensitivity as well as total (0.00-0.40 Hz), low frequency (0.04-0.15 Hz) and high frequency (0.15-0.40 Hz) power bands of the heart rate variability spectrum. Ritodrine significantly increased mean heart rate and the low frequency power band of the systolic blood pressure variability spectrum. CONCLUSIONS: In pregnant women with threatened preterm labour intravenous administration of ritodrine decreases vagal cardiac baroreflex sensitivity and vagal modulation of heart rate, and increases sympathetically mediated blood pressure variability. Decreased baroreflex sensitivity and heart rate variability are known to be associated with a poor prognosis in some patient groups, so the effects of ritodrine tocolysis may be unfavourable in women with impaired circulatory homeostasis.


Subject(s)
Adrenergic beta-Agonists/pharmacology , Autonomic Nervous System/drug effects , Hemodynamics/drug effects , Ritodrine/pharmacology , Tocolytic Agents/pharmacology , Adolescent , Adult , Autonomic Nervous System/physiopathology , Baroreflex/drug effects , Blood Pressure/drug effects , Female , Heart Rate/drug effects , Humans , Obstetric Labor, Premature/drug therapy , Obstetric Labor, Premature/physiopathology , Pregnancy
4.
Eur J Obstet Gynecol Reprod Biol ; 76(2): 153-6, 1998 Feb.
Article in English | MEDLINE | ID: mdl-9481565

ABSTRACT

OBJECTIVE: The aim of this study was to assess whether baroreflex sensitivity can be measured in a non-invasive manner with the Valsalva manoeuvre in pregnancy. STUDY DESIGN: Baroreflex sensitivity was measured from the reflex response to phenylephrine injection and phase four of the Valsalva manoeuvre in nine pregnant women at 27 (range 24-33) gestational weeks. RESULTS: Both the phenylephrine test and the Valsalva manoeuvre yielded similar estimates of baroreflex sensitivity (9.3 (4.1) ms/mmHg vs. 8.0 (5.2) ms/mmHg, Pearson's correlation coefficient r = 0.81, P < 0.008, linear regression BRSValsalva (ms/mmHg) = 1.03 x BRSPhenylephrine + 1.59). Comparable changes in heart rate and blood pressure were obtained with the phenylephrine test and the Valsalva manoeuvre. CONCLUSION: The physiological challenge caused by the Valsalva manoeuvre can be used to measure baroreflex sensitivity in pregnancy. A possibility to study baroreflex function non-invasively, without pharmacological intervention, benefits future research of blood pressure regulation in pregnancy.


Subject(s)
Baroreflex/physiology , Pregnancy/physiology , Valsalva Maneuver , Adult , Blood Pressure , Female , Heart Rate , Humans , Phenylephrine , Vasoconstrictor Agents
5.
Am J Obstet Gynecol ; 177(5): 1208-12, 1997 Nov.
Article in English | MEDLINE | ID: mdl-9396920

ABSTRACT

OBJECTIVE: Our purpose was to study whether cardiovascular changes in pregnancy-induced hypertension are associated with the increase in sympathetic control of hemodynamics and change in sympathovagal balance. STUDY DESIGN: Fourteen women with pregnancy-induced hypertension and 16 women with uncomplicated pregnancies of similar duration were studied. Electrocardiographic signals and arterial blood pressure (Finapres monitor, Ohmeda) were continuously measured noninvasively throughout the study. Heart rate and blood pressure were measured while the subject was breathing (1) with her normal tidal volume at a frequency of 15 breaths per minute and (2) as deeply as possible at a frequency of six breaths per minute. Heart rate and systolic blood pressure variability were calculated with use of the autoregressive model of spectral analysis. RESULTS: Heart rate and systolic blood pressure variabilities were significantly increased in women with pregnancy-induced hypertension compared with normotensive pregnant women. This increase was greatest in the high frequency component of heart rate variability (p = 0.02) while the women were breathing with a normal tidal volume. Further, the medium frequency (p = 0.03) and high-frequency variabilities (p = 0.03) of systolic blood pressure were significantly increased in women with preeclampsia compared with normotensive pregnant subjects. CONCLUSIONS: Neural control of the heart rate and blood pressure are disturbed in pregnancy-induced hypertension, as shown by increased heart rate and blood pressure variability. Both the sympathetic and parasympathetic control of the heart rate and blood pressure appear to be increased. The maladaptation of the cardiovascular system in women with pregnancy-induced hypertension is manifested as a lack of the physiologic decline in cardiovascular oscillations.


Subject(s)
Blood Pressure , Heart Rate , Hypertension/physiopathology , Pregnancy Complications, Cardiovascular/physiopathology , Adolescent , Adult , Autonomic Nervous System/physiology , Female , Humans , Pregnancy
6.
Br J Obstet Gynaecol ; 104(7): 825-8, 1997 Jul.
Article in English | MEDLINE | ID: mdl-9236648

ABSTRACT

OBJECTIVE: To examine frequency domain measures of heart rate variability and their circadian rhythms in pregnancy. DESIGN: A longitudinal study. SETTING: University hospital in Turku, Finland. PARTICIPANTS: Sixteen healthy women between 11 and 27 weeks of pregnancy; 12 women before pregnancy; and four women postpartum. MAIN OUTCOME MEASURES: Heart rate variability as measured in frequency domain from 24-hour ambulatory electrocardiography. RESULTS: Pregnancy was associated with a lower standard deviation of R-R intervals (P < 0.01), with reduced very low (P < 0.05), low (P < 0.01), and high frequency (P < 0.05) power spectral components of heart rate variability. The high frequency power was lower at night in pregnancy, but similar in the daytime in pregnant and nonpregnant women. CONCLUSIONS: Pregnancy is associated with an overall reduction in heart rate variability, most markedly reflected in the low frequency component. This suggests altered baroreflex or sympathetic modulation of heart rate, and decreased vagal activation at night.


Subject(s)
Circadian Rhythm/physiology , Heart Rate/physiology , Pregnancy/physiology , Adult , Electrocardiography, Ambulatory , Female , Humans , Longitudinal Studies , Postpartum Period/physiology
7.
Eur J Obstet Gynecol Reprod Biol ; 64(1): 29-36, 1996 Jan.
Article in English | MEDLINE | ID: mdl-8801145

ABSTRACT

Pregnancy is associated with profound adaptive changes in the maternal hemodynamics. Although the autonomic nervous system plays a central role in the adaptation of the cardiovascular system to various needs, its role in the adaptation of the circulation to the demands of pregnancy is poorly understood. This paper reviews the literature of autonomic cardiovascular control in pregnancy as studied with the cardiovascular reflex tests. A Medline search and manual cross-referencing for prior publications were used. All papers found on the hemodynamic effects of the Valsalva maneuver, the orthostatic test, the deep breathing test, the isometric handgrip test and maternal heart rate variability in pregnancy were reviewed and all publications that studied short-term changes in maternal heart rate and blood pressure were included. The beginning of pregnancy is associated with sympathetic reactivity, whereas the latter half of pregnancy is characterized by increased hemodynamic stability during orthostatic stress. The heart rate response to the Valsalva maneuver is blunted in mid-pregnancy, possibly due to changes in the baroreflex and increased maternal blood volume. Heart rate variability is significantly reduced in the second trimester. Cardiovascular reflex tests can be used to study drug effects on maternal circulation non-invasively.


Subject(s)
Cardiovascular Physiological Phenomena , Hemodynamics/physiology , Pregnancy/physiology , Blood Pressure , Exercise , Female , Heart Rate , Humans , Valsalva Maneuver
8.
Clin Auton Res ; 4(4): 161-5, 1994 Aug.
Article in English | MEDLINE | ID: mdl-7849495

ABSTRACT

Cardiovascular reflexes were studied in 22 healthy women before they were pregnant, once during each pregnancy trimester and after delivery to evaluate the effect of pregnancy on autonomic control of haemodynamics. The Valsalva manoeuvre, the deep breathing test, the orthostatic test and the isometric handgrip test were used to assess changes in autonomic nervous function. We found that pregnancy altered the heart rate response in the Valsalva manoeuvre, the deep breathing test and the orthostatic tests. The deep breathing difference (p = 0.03) and max/min ratio (p = 0.03) decreased in pregnancy, whereas standing heart rate increased (p < 0.0001). Both the systolic and diastolic blood pressure increased after standing up during pregnancy. The circulatory responses to isometric exercise were not affected by pregnancy. The results show that parasympathetic responsiveness is decreased in pregnancy and that it returns to normal after delivery.


Subject(s)
Autonomic Nervous System/physiology , Cardiovascular Physiological Phenomena , Hemodynamics/physiology , Postpartum Period/physiology , Pregnancy/physiology , Reflex/physiology , Adult , Evaluation Studies as Topic , Female , Humans , Longitudinal Studies , Posture/physiology , Valsalva Maneuver
9.
Br J Obstet Gynaecol ; 100(2): 177-82, 1993 Feb.
Article in English | MEDLINE | ID: mdl-8476812

ABSTRACT

OBJECTIVE: To study the physiological responses to noninvasive cardiovascular autonomic function tests in normal pregnancy. DESIGN: Cardiovascular autonomic responses in 60 women at 22 to 29 weeks gestation and 62 nonpregnant women were investigated using the Valsalva manoeuvre as well as orthostatic, quiet breathing, deep breathing, and isometric handgrip tests. RESULTS: Compared with nonpregnant women, those who were pregnant showed significantly lower heart rate variability during normal breathing and a blunted tachycardic reaction to blowing during the Valsalva manoeuvre. The vagally controlled biphasic heart rate response to standing was also attenuated in the pregnant group. CONCLUSIONS: The cardiovascular responses were blunted in mid-pregnancy indicating a decrease in parasympathetic cardiovascular control.


Subject(s)
Autonomic Nervous System/physiology , Heart Rate/physiology , Hemodynamics , Pregnancy/physiology , Adult , Blood Pressure , Electrocardiography , Female , Gestational Age , Humans , Parity , Reflex , Respiration/physiology , Valsalva Maneuver/physiology
10.
Am J Obstet Gynecol ; 167(5): 1262-6, 1992 Nov.
Article in English | MEDLINE | ID: mdl-1442975

ABSTRACT

OBJECTIVE: Our goal was to study the sleep quality in women with preeclampsia with a special reference to nocturnal body movement activity. STUDY DESIGN: Sleep quality was evaluated in nine women with preeclampsia and eight women with normal term pregnancy by means of questionnaires and by recording the nocturnal body movement activity with the static charge-sensitive bed. RESULTS: Subjective sleep complaints were similar in both groups. The total movement time and the total frequency of body movements in bed were, however, significantly increased in the preeclamptic group. CONCLUSION: The study suggests that sleep is impaired in preeclamptic subjects.


Subject(s)
Pre-Eclampsia/physiopathology , Sleep , Adult , Beds , Equipment Design , Female , Humans , Movement , Pregnancy , Sleep/physiology
11.
Clin Physiol ; 12(5): 527-36, 1992 Sep.
Article in English | MEDLINE | ID: mdl-1395445

ABSTRACT

Spectral analysis of heart rate variability was used to study autonomic nervous control in mid-pregnancy. Fifty women (age 22-36 years) with singleton pregnancies (mean duration of gestation 27.7 weeks) and 39 non-pregnant female controls (age 21-39 years) were studied using controlled breathing and orthostatic tests. During spontaneous breathing the overall heart rate variability was lower in pregnant subjects indicating a decreased parasympathetic tone at rest. The decreased parasympathetic tone probably counts for the increased heart rate in pregnancy. The parasympathetic efferent capacity of autonomic cardiac control was found to be similar in pregnant and non-pregnant subjects, as no difference was seen during controlled breathing in periodic heart rate variability between the groups. Standing up caused a similar change in low frequency and mid-frequency bands in both groups, but high frequency heart rate variability increased in pregnant subjects and decreased in the controls indicating an increased sympathetic tone at rest in mid-pregnancy.


Subject(s)
Autonomic Nervous System/physiology , Hemodynamics/physiology , Pregnancy/physiology , Adult , Electrocardiography , Female , Heart Rate/physiology , Humans , Respiratory Function Tests , Respiratory Mechanics/physiology
SELECTION OF CITATIONS
SEARCH DETAIL
...