150. Uteroplacental acute atherosis, cardiovascular biomarkers and vasoactive hormones in pregnancy

Introduction Cardiovascular disease (CVD) is the leading cause of death for women. A history of hypertensive disorders of pregnancy increases the risk. Uteroplacental spiral arterial.acute atherosis is a pregnancy-specific lesion resembling early atherosclerosis, frequently found in preeclampsia. The renin-angiotensin-system (RAS) plays a role in atherosclerosis and is dysregulated in preeclampsia. RAS and natriuretic peptides are physiological opponents in the regulation of arterial blood pressure and intravascular volume control. We previously reported increased concentrations of the natriuretic hormone precursor midregional proatrial natriuretic peptide (MR-proANP) in preeclampsia and suggested a cardiac origin. Objective To assess whether uteroplacental acute atherosis correlates with cardiovascular biomarkers and vasoactive hormones in maternal circulation at delivery in preeclamptic and normotensive pregnancies. Methods Third trimester maternal blood samples were analyzed for renin, prorenin and MR-proANP [normotensive pregnancies n = 50, preeclampsia (PE) n = 71]. Decidua basalis tissue for acute atherosis diagnosis (immunohistochemistry) was available for 53 of these pregnancies (normotensives n = 25 and PE n = 28). Statistical analyses: Skewed data were log-transformed. Linear regression and Fisher’s Exact test were applied as appropriate. A p-value Results A negative correlation between renin and MR-proANP concentrations was confirmed for both study groups. The presence of acute atherosis was not associated with maternal levels of circulating renin, prorenin or MR-proANP. Presence of acute atherosis was neither associated with MR-proANP/renin ratio nor maternal renin in the lower 2 quartiles in combination with MR-proANP in the upper 2 quartiles (normotensives p = 1.0 and PE p = 0.7). Discussion This is the first report on RAS and vasoactive hormones in pregnancy in relation to uteroplacental acute atherosis. We find that maternal circulating biomarkers previously shown to indicate hemodynamic stress in preeclampsia are not increased in pregnancies with acute atherosis. Further studies exploring the longitudinal association between maternal circulating cardiovascular biomarkers and postpartum CVD surrogate markers are underway.