Exposure to experimental preeclampsia in mice enhances the vascular response to future injury

D Pruthi, EV Khankin, RM Blanton, M Aronovitz… - …, 2015 - Am Heart Assoc
D Pruthi, EV Khankin, RM Blanton, M Aronovitz, SD Burke, A McCurley, SA Karumanchi
Hypertension, 2015Am Heart Assoc
Cardiovascular disease (CVD) remains the leading killer of women in developed nations.
One sex-specific risk factor is preeclampsia, a syndrome of hypertension and proteinuria that
complicates 5% of pregnancies. Although preeclampsia resolves after delivery, exposed
women are at increased long-term risk of premature CVD and mortality. Pre-existing CVD
risk factors are associated with increased risk of developing preeclampsia but whether
preeclampsia merely uncovers risk or contributes directly to future CVD remains a critical …
Cardiovascular disease (CVD) remains the leading killer of women in developed nations. One sex-specific risk factor is preeclampsia, a syndrome of hypertension and proteinuria that complicates 5% of pregnancies. Although preeclampsia resolves after delivery, exposed women are at increased long-term risk of premature CVD and mortality. Pre-existing CVD risk factors are associated with increased risk of developing preeclampsia but whether preeclampsia merely uncovers risk or contributes directly to future CVD remains a critical unanswered question. A mouse preeclampsia model was used to test the hypothesis that preeclampsia causes an enhanced vascular response to future vessel injury. A preeclampsia-like state was induced in pregnant CD1 mice by overexpressing soluble fms-like tyrosine kinase-1, a circulating antiangiogenic protein that induces hypertension and glomerular disease resembling human preeclampsia. Two months postpartum, soluble fms-like tyrosine kinase-1 levels and blood pressure normalized and cardiac size and function by echocardiography and renal histology were indistinguishable in preeclampsia-exposed compared with control mice. Mice were then challenged with unilateral carotid injury. Preeclampsia-exposed mice had significantly enhanced vascular remodeling with increased vascular smooth muscle cell proliferation (180% increase; P<0.01) and vessel fibrosis (216% increase; P<0.001) compared with control pregnancy. In the contralateral uninjured vessel, there was no difference in remodeling after exposure to preeclampsia. These data support a new model in which vessels exposed to preeclampsia retain a persistently enhanced vascular response to injury despite resolution of preeclampsia after delivery. This new paradigm may contribute to the substantially increased risk of CVD in woman exposed to preeclampsia.
Am Heart Assoc