microcirculationРегионарное кровообращение и микроциркуляцияRegional blood circulation and microcirculation1682-66552712-9756Academician I.P. Pavlov First St. Petersburg State Medical University10.24884/1682-6655-2016-15-2-51-59microcirculation-69Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLES (CLINICAL INVESTIGATIONS)Особенности параметров периферического, центрального артериального давления и показателей ригидности сосудов у беременных с гипертензивными состояниямиFeatures of parameters of peripheral, central blood pressure and indicators of vessels rigidity in pregnant women with hypertensive disordersДороговаИ. В.DorogovaI. V.i.dorogova@mail.ruУсановВ. Д.UsanovV. D.viсtor.usanov@gmail.comБартошЛ. Ф.BartosL. F.rodino091@rambler.ruПанинаЕ. С.PaninaE. S.panina.es@mail.ruБочарниковД. Ю.BocharnikovD. Y.roddom@sura.ruПензенский институт усовершенствования врачейРоссияPenza Institute for Advanced Medical Studies, Penza, RussiaRussian FederationПензенский государственный университетРоссияPenza State University, Penza, RussiaRussian FederationПензенский государственный университет; Городской родильный домРоссияPenza State University, Penza, Russia; City Maternity Hospital, Penza, RussiaRussian Federation2016300620161525159Copyright © Дорогова И.В., Усанов В.Д., Бартош Л.Ф., Панина Е.С., Бочарников Д.Ю., 20162016Дорогова И.В., Усанов В.Д., Бартош Л.Ф., Панина Е.С., Бочарников Д.Ю.Dorogova I.V., Usanov V.D., Bartos L.F., Panina E.S., Bocharnikov D.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.microcirc.ru/jour/article/view/69

Цель исследования - изучить особенности параметров периферического, центрального артериального давления и показателей ригидности сосудов у беременных с физиологической беременностью, артериальной гипертонией, имевшейся до беременности, и гестационной артериальной гипертонией. Материал и методы исследования. Суточное мониторирование артериального давления (СМАД) выполнялось с использованием системы BPLab Vasotens (ООО «Петр Телегин», Россия). Прибор позволяет определять время распространения отраженной волны (RWTT), индекс аугментации в плечевой артерии (AIx) и аорте (AIхао), индекс ригидности артерий (АSI), параметры центрального артериального давления (АД). Проанализированы данные 116 женщин в сроке беременности 30-39 недель, из них с нормальным АД (Н), n=42; с артериальной гипертонией, имевшейся до беременности (АГДБ) - n=30; с гестационной АГ (ГАГ) - n=24; с преэклампсией (ПЭ) - n=20. Различия считались статистически значимыми при р<0,05. Результаты исследования. Выявлен циркадный ритм центрального АД и показателей ригидности сосудов у беременных независимо от нормотензивного или гипертензивного статуса. Изучаемые показатели были значимо выше в группе беременных с ГАГ и ПЭ по сравнению с Н и АГДБ. Выявлена достоверная взаимосвязь между RWTT и AIx, AIx и AIхао. Выводы. Данные, полученные при суточном мониторирования центрального АД и ригидности артерий, могут быть использованы в качестве дополнительных показателей для диагностики АГ у беременных.

Purpose. To study the parameters of peripheral and central blood pressure as well as the vascular rigidity parameters in pregnant women with physiological pregnancy and hypertensive disorders. Materials and methods. ABPM was performed using BPLab Vasotens system («Petr Telegin», Russia). The device allows to determine the propagation time of the reflected wave (RWTT), augmentation index in the brachial artery (AIx) and aorta (AIxao), arterial stiffness index (ASI), the parameters of the central blood pressure (BP). The data of 116 women in 30-39 week gestation were analyzed. The groups were: normotensive women (N), n = 42, arterial hypertension existing before pregnancy (AHBP), n = 30, gestational arterial hypertension (GAH), n = 24, and preeclampsia (PE), n = 20. Differences were considered significant at p<0.05. Results. The circadian rhythm of the central arterial blood pressure and indicators of rigidity was revealed in pregnant women regardless of normotensive or hypertensive status. The studied parameters were significantly higher in the group of pregnant women with GAH and PE compared to N and AHBP. The correlation between RWTT and AIx, AIx and AIxao was found. Conclusions. Data obtained by daily monitoring of central blood pressure and arterial stiffness can be used as additional indicators for the diagnosis of hypertension in pregnant women.

артериальная гипертония у беременныхсуточное мониторирование центрального давленияиндекс аугментациивремя распространения отраженной волныhypertension in pregnant womenambulatory central blood pressure monitoringaugmentation indexthe reflected wave travel timeReferencesБаранова Е. И. Артериальная гипертензия у беременных // Артериальная гипертензия. 2006. Т. 12. № 1. С. 7-15.Баранова Е. И. Артериальная гипертензия у беременных // Артериальная гипертензия. 2006. Т. 12. № 1. С. 7-15.Ageenkova О. A., Purygina M. A. Central aortic blood pressure, augmentation index, and refected wave transit time: reproducibility and repeatability of data obtained by oscillometry // Vascular Health and Risk Management. 2011. Vol. 7. № 1. Р. 649-656.Ageenkova О. A., Purygina M. A. Central aortic blood pressure, augmentation index, and refected wave transit time: reproducibility and repeatability of data obtained by oscillometry // Vascular Health and Risk Management. 2011. Vol. 7. № 1. Р. 649-656.Bogaard B., Westerhof B. E., Best H. et al. Arterial wave refection decreases gradually from supine to upright // Blood Pressure. 2011. Vol. 20. № 6. P. 370-375.Bogaard B., Westerhof B. E., Best H. et al. Arterial wave refection decreases gradually from supine to upright // Blood Pressure. 2011. Vol. 20. № 6. P. 370-375.Dorogova I. V., Panina E. S. Comparison of the BPlab® sphygmomanometer for ambulatory blood pressure monitoring with mercury sphygmomanometry in pregnant women: validation study according to the British Hypertension society protocol // Vascular Health and Risk Management. 2015. № 11. P. 245-249.Dorogova I. V., Panina E. S. Comparison of the BPlab® sphygmomanometer for ambulatory blood pressure monitoring with mercury sphygmomanometry in pregnant women: validation study according to the British Hypertension society protocol // Vascular Health and Risk Management. 2015. № 11. P. 245-249.Kips J. G., Vermeersch S. J., Reymond P. et al. Ambulatory arterial stifness index does not accurately assess arterial stiffness // Journal of Hypertension. 2012. Vol. 30. № 3. P. 574-580.Kips J. G., Vermeersch S. J., Reymond P. et al. Ambulatory arterial stifness index does not accurately assess arterial stiffness // Journal of Hypertension. 2012. Vol. 30. № 3. P. 574-580.Kollias A., Stergiou G. S., Dolan E. et al. Ambulatory arterial stifness index: a systematic review and meta-analysis // Atherosclerosis. 2012. Vol. 224. № 2. P. 291-301.Kollias A., Stergiou G. S., Dolan E. et al. Ambulatory arterial stifness index: a systematic review and meta-analysis // Atherosclerosis. 2012. Vol. 224. № 2. P. 291-301.Kotovskaya Y. V., Kobalava Z. D., Orlov A. V. Validation of the integration of technology that measures additional «vascular» indices into an ambulatory blood pressure monitoring system // Medical Devices: Evidence and Research. 2014. Vol. 7. № 1. P. 91-97.Kotovskaya Y. V., Kobalava Z. D., Orlov A. V. Validation of the integration of technology that measures additional «vascular» indices into an ambulatory blood pressure monitoring system // Medical Devices: Evidence and Research. 2014. Vol. 7. № 1. P. 91-97.Kuznetsova T. Y., Korneva V. A., Bryantseva E. N. et al. Te 24-hour pulse wave velocity, aortic augmentation index, and central blood pressure in normotensive volunteers // Vascular Health and Risk Management. 2014. Vol. 10. P. 247-251.Kuznetsova T. Y., Korneva V. A., Bryantseva E. N. et al. Te 24-hour pulse wave velocity, aortic augmentation index, and central blood pressure in normotensive volunteers // Vascular Health and Risk Management. 2014. Vol. 10. P. 247-251.McEniery C. M., Cockcrof J. R., Roman M. J. et al. Central blood pressure: current evidence and clinical importance // Eur. Heart Journ. 2014. Vol. 35. № 26. P. 1719-1725.McEniery C. M., Cockcrof J. R., Roman M. J. et al. Central blood pressure: current evidence and clinical importance // Eur. Heart Journ. 2014. Vol. 35. № 26. P. 1719-1725.Oakley C., Warnes C. A. Heart Disease in Pregnancy. 2nd ed. Oxford: Wiley-Blackwell, 2007. 354 p.Oakley C., Warnes C. A. Heart Disease in Pregnancy. 2nd ed. Oxford: Wiley-Blackwell, 2007. 354 p.Omboni S., Posokhov I. N., Rogoza A. N. Evaluation of 24-Hour Arterial Stiffness Indices and Central Hemodynamics in Healthy Normotensive Subjects versus Treated or Untreated Hypertensive Patients: A Feasibility Study // Corporation International Journal of Hypertension. 2015. Vol. 2015. ID 601812. 10 p. URL: http://dx.doi.org/10.1155/2015/601812Omboni S., Posokhov I. N., Rogoza A. N. Evaluation of 24-Hour Arterial Stiffness Indices and Central Hemodynamics in Healthy Normotensive Subjects versus Treated or Untreated Hypertensive Patients: A Feasibility Study // Corporation International Journal of Hypertension. 2015. Vol. 2015. ID 601812. 10 p. URL: http://dx.doi.org/10.1155/2015/601812Papaioannou T. G., Argyris A., Protogerou A. D. et al. Non-invasive 24 hour ambulatory monitoring of aortic wave refection and arterial stifness by a novel oscillometric device: the First Feasibility and Reproducibility Study // International Journ. of Cardiology. 2013. Vol. 169. № 1. P. 57-61.Papaioannou T. G., Argyris A., Protogerou A. D. et al. Non-invasive 24 hour ambulatory monitoring of aortic wave refection and arterial stifness by a novel oscillometric device: the First Feasibility and Reproducibility Study // International Journ. of Cardiology. 2013. Vol. 169. № 1. P. 57-61.Report ofthe National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy // Am. J. Obstet. Gynecol. 2000. № 183. P. S1-S22.Report ofthe National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy // Am. J. Obstet. Gynecol. 2000. № 183. P. S1-S22.Rogoza A. N., Kuznetsov A. A. Central aortic blood pressure and augmentation index: comparison between Vasotens and SphygmoCor technology // Research Reports in Clinical Cardiology. 2012. Vol. 3. P. 27-33.Rogoza A. N., Kuznetsov A. A. Central aortic blood pressure and augmentation index: comparison between Vasotens and SphygmoCor technology // Research Reports in Clinical Cardiology. 2012. Vol. 3. P. 27-33.Stoner L., Faulkner J., Lowe A. et al. Should the augmentation index be normalized to heart rate? // Journal of Atherosclerosis and Trombosis. 2014. Vol. 21. № 1. P. 11-16.Stoner L., Faulkner J., Lowe A. et al. Should the augmentation index be normalized to heart rate? // Journal of Atherosclerosis and Trombosis. 2014. Vol. 21. № 1. P. 11-16.Sugawara J., Komine H., Hayashi K. et al. Relationship between augmentation index obtainedfrom carotid and radial artery pressure waveforms // Journ. of Hypertension. 2007. Vol. 25. № 2. P. 375-381.Sugawara J., Komine H., Hayashi K. et al. Relationship between augmentation index obtainedfrom carotid and radial artery pressure waveforms // Journ. of Hypertension. 2007. Vol. 25. № 2. P. 375-381.Takazawa K., Kobayashi H., Shindo N. et al. Relationship between radial and central arterial pulse wave and evaluation of central aortic pressure using the radial arterial pulse wave // Hypertension Research. 2007. Vol. 30. № 3. P. 219-228.Takazawa K., Kobayashi H., Shindo N. et al. Relationship between radial and central arterial pulse wave and evaluation of central aortic pressure using the radial arterial pulse wave // Hypertension Research. 2007. Vol. 30. № 3. P. 219-228.Trachet B., Reymond P., Kips J. et al. Numerical validation of a new method to assess aortic pulse wave velocity from a single recording of a brachial artery waveform with an occluding cuf // Annals of Biomedical Engineering. 2010. Vol. 38. № 3. P. 876-888.Trachet B., Reymond P., Kips J. et al. Numerical validation of a new method to assess aortic pulse wave velocity from a single recording of a brachial artery waveform with an occluding cuf // Annals of Biomedical Engineering. 2010. Vol. 38. № 3. P. 876-888.Villar J., Say L., Shennan A. et al. Methodological and technical issues related to the diagnosis, screening, prevention, and treatment of pre-eclampsia and eclampsia // Int. J. Gynaecol. Obstet. 2004. № 85 (1). P. S28-S41.Villar J., Say L., Shennan A. et al. Methodological and technical issues related to the diagnosis, screening, prevention, and treatment of pre-eclampsia and eclampsia // Int. J. Gynaecol. Obstet. 2004. № 85 (1). P. S28-S41.Vlachopoulos C., Aznaouridis K., Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stifness: a systematic review and meta-analysis // Journ. of the American College of Cardiology. 2010. Vol. 55. № 13. P. 1318-1327.Vlachopoulos C., Aznaouridis K., Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stifness: a systematic review and meta-analysis // Journ. of the American College of Cardiology. 2010. Vol. 55. № 13. P. 1318-1327.Williams B., Lacy P. S., Baschiera F. et al. Novel description of the 24-hour circadian rhythms of brachial versus central aortic blood pressure and the impact of blood pressure treatment in a randomized controlled clinical trial: the ambulatory central aortic pressure (AmCAP) // Hypertension. 2013. Vol. 61. № 6. P. 1168-1176.Williams B., Lacy P. S., Baschiera F. et al. Novel description of the 24-hour circadian rhythms of brachial versus central aortic blood pressure and the impact of blood pressure treatment in a randomized controlled clinical trial: the ambulatory central aortic pressure (AmCAP) // Hypertension. 2013. Vol. 61. № 6. P. 1168-1176.

The authors declare that there are no conflicts of interest present.