Abstract Body: Background: Preeclampsia (PE), a major cause of maternal and fetal morbidity, requires improved diagnostics. Using unbiased proteomics and verification by ELISA, we identified vasorin (VASN) and angiotensinogen (AGT) as potential biomarkers, noting their gestational age-dependent changes in normal pregnancy and dysregulation in PE. VASN is significantly decreased and AGT is significantly increased in severe PE (sPE) vs normotensive controls (NTP).
Hypothesis: This study hypothesizes that altered VASN and VASN/AGT ratios correlate with flow-mediated endothelium-dependent dilation (FMD) by VENDYS analysis in women with PE.
Methods: This cross-sectional study included 13 women with sPE and 16 matched NTP. Levels of VASN and AGT in plasma samples were determined by ELISA. The vascular reactivity index (VRI) was determined by the VENDYS instrument (Endothelix) at bedside. The Vendys instrument estimates vascular reactivity by measuring the temperature in the index fingers on both hands, while one side is temporarily occluded for 5 minutes. The VRI was calculated from the area under the curve (AUC) of the temperature increase after reperfusion in the transiently occluded arm, normalized to the temperature in the control (nonoccluded) finger and adjusted for ambient temperature.
Results: NTP patients had consistent VRI measurements centered around a mean of 2.05. In contrast, sPE patients showed a wide range of VRI values, mostly below 2, with a mean of 1.44, significantly lower than NTP (p=0.004). VASN showed a weak, non-significant positive correlation with VRI (Y=6323*X+613; p=0.327). AGT (Y=-569331*X+1619937; p=0.024) and AGT/VASN (Y=-292.2*X+678.8; p=0.025) both exhibited significant inverse correlations with FMD as determined by simple linear regression.
Conclusion: The study demonstrates that VASN has a weak positive correlation with VRI, while AGT and the AGT/VASN ratio show significant inverse correlations with VRI. These findings suggest that VASN may modestly enhance vascular function, whereas elevated AGT levels and the AGT/VASN ratio are linked to impaired vascular reactivity in PE.