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Maternal Medicine Posters
Effect of S-nitrosoglutathione on arterial stiffness in women with severe preeclampsia and healthy controls
  1. TR Everett1,
  2. AA Mahendru1,
  3. CM McEniery2,
  4. IB Wilkinson2,
  5. CC Lees1
  1. 1Dept of Fetal Medicine, Rosie Hospital, Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom
  2. 2Dept of Clinical Pharmacology, University of Cambridge, Cambridge, United Kingdom

Abstract

Introduction Pre-eclampsia and increased arterial stiffness are associated with cardiovascular disease later in life. Arterial stiffness is raised in preeclampsia. Augmentation index (AIx) is a non-invasive method of assessing arterial stiffness. Despite evidence of endothelial dysfunction in pre-eclampsia, there is no pharmacotherapeutic substance targeted at this underlying pathophysiology. S-nitrosoglutathione (GSNO) is an endogenously occurring nitric oxide donor that may ameliorate endothelial dysfunction. We performed intravenous GSNO infusions in healthy non-pregnant volunteers and women with severe preeclampsia.

Controls Four healthy volunteers underwent GSNO infusion at 10 and 30mcg/min. Doses were increased at 30min intervals maintaining BP >110/60mmHg.

Pre-eclampsia: Four women with early-onset preeclampsia underwent GSNO infusion at 10 and 30mcg/min. Doses were increased at 30min intervals maintaining BP >140/80mmHg.

For each infusion, AIx was assessed pre- and post-infusion and at each dose point. AIx and mean arterial pressure (MAP) were compared to initial readings at each dose using a paired t-test.

Controls Significant reduction in AIx was seen at 10mcg/min (p=0.025) and 30mcg/min (p=0.005). No reduction in MAP was seen.

Pre-eclampsia: No changes in AIx, and a small reduction in MAP (4mmHg, p=0.02), were seen at 10mcg/min (p=0.02). At 30mcg/min GSNO, AIx significantly reduced (p=0.02) and MAP remained unchanged

Conclusion GSNO infusion in early-onset preeclampsia and healthy volunteers can significantly decrease arterial stiffness with only minimal effect on MAP. Our results suggest GSNO may be a useful adjunct to current antihypertensive treatment for preeclampsia and a Phase 1 trial is planned.

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