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Objective  Pre‐eclampsia ( PE ) is associated with an increased risk of cardiovascular disease later in life. In cases with  PE  there is a substantial increase in levels of the antiangiogenic factor soluble fms‐like tyrosine kinase‐1 ( sFlt ‐1) and decreased levels of the proangiogenic factor placental growth factor ( PlGF ). Elevated levels of  sFlt ‐1 are also found in individuals with cardiovascular disease. The aims of this study were to assess levels of  sFlt ‐1,  PlGF  and the  sFlt ‐1/ PlGF  ratio and their correlation with signs of arterial aging by measuring the common carotid artery ( CCA ) intima and media thicknesses and their ratio (I/M ratio) in women with and without  PE .    Methods  Serum  sFlt ‐1 and  PlGF  levels were measured using commercially available enzyme‐linked immunosorbent assay kits, and  CCA  intima and media thicknesses were estimated using high‐frequency (22‐ MHz ) ultrasonography in 55 women at  PE  diagnosis and in 64 women with normal pregnancy at a similar gestational age, with reassessment at 1 year postpartum.    Results  During pregnancy, higher levels of  sFlt ‐1, lower levels of  PlGF , a thicker intima, a thinner media and a higher I/M ratio of the  CCA  were found in women with  PE   vs  controls (all  P  < 0.0001). Further,  sFlt ‐1 and the  sFlt ‐1/ PlGF  ratio were positively correlated with intima thickness and I/M ratio (all  P  < 0.0001). At 1 year postpartum, levels of  sFlt ‐1 and the  sFlt ‐1/ PlGF  ratio had decreased in both groups; however, their levels in the  PE  group were still higher than in the controls ( P  = 0.001 and < 0.0001, respectively). Levels of  sFlt ‐1  and the  sFlt ‐1/ PlGF  ratio remained positively correlated with intima thickness and I/M ratio at 1 year postpartum.    Conclusions  Higher  sFlt ‐1 levels and  sFlt ‐1/ PlGF  ratio in women with  PE  were positively associated with signs of arterial aging during pregnancy. At 1 year postpartum,  sFlt ‐1 levels and the  sFlt ‐1/ PlGF  ratio were still higher in the  PE  group and were associated with the degree of arterial aging. © 2016 The Authors.  Ultrasound in Obstetrics & Gynecology  published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.

Association between angiogenic factors and signs of arterial aging in women with pre‐eclampsia