1.Abnormal Microvascular Reactivity with Hypercholesterolaemia in Pregnancy
Aida Hanum Ghulam Rasool ; Aisyah Syairah Abdul Rahman ; Nor Aliza Abd Ghaffar ; Nik Mohd Zaki Nik Mahmood ; Abd Rahim Wong
Malaysian Journal of Medical Sciences 2010;17(4):14-19
Background: Post-occlusive skin reactive hyperaemia (PORH) is a model used to assess microvascular reactivity. This study aims to compare PORH response among pregnant
hypercholesterolaemic patients with age and gestational age-matched controls.
Methods: This cross sectional study involved 17 hypercholesterolaemic, pregnant women
and 20 pregnant controls entering their early third trimester. Laser Doppler fluximetry (LDF) was
used to measure skin perfusion. The process of PORH was performed by occluding the upper arm
with an occlusion cuff at 200 mmHg for 3 minutes. Skin perfusion was recorded before, during, and
after occlusion release. Baseline perfusion, time to achieve peak perfusion (Tp), peak perfusion after
occlusion release (PORHpeak), and maximum change in perfusion due to occlusion (PORHmax) were
recorded.
Results: Serum total cholesterol (TC) was significantly different (P < 0.001) between the 2 groups: 7.25 (SEM 0.18) mmol/L for hypercholesterolaemic women and 5.54 (SEM 0.15) mmol/L for the control group. There were no significant differences in their baseline, PORHpeak, and PORHmax. However, Tp in the hypercholesterolaemic group was significantly increased (P = 0.024) compared
with the controls at 14.9 (SEM 0.6) seconds and 13.1 (SEM 0.5) seconds, respectively.
Conclusion: Pregnant hypercholesterolaemic patients showed an abnormal microvascular reactivity response. Tp with ischemia was significantly increased compared with
normocholesterolaemic controls.