Hypertension research : official journal of the Japanese Society of Hypertension
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Our aim was to evaluate the onset threshold of plasma levels of the soluble fms-like tyrosine kinase 1 (sFlt-1)/placental growth factor (PlGF) ratio for predicting the imminent onset of preeclampsia (PE) within 4 weeks after blood sampling. We prospectively measured the plasma levels of sFlt-1 and PlGF by an automated electrochemiluminescence immunoassay at 19-25 weeks of gestation in 1199 women and at 26-31 weeks of gestation in 798 women. ⋯ The onset threshold of plasma levels of the sFlt-1/PlGF ratio at 19-25 weeks showed a sensitivity (SE) of 1.00, a specificity (SP) of 1.00, a positive likelihood ratio (LR+) of ∞ and a positive predictive value (PPV) of 1.00; the onset threshold of plasma levels of the sFlt-1/PlGF ratio at 26-31 weeks showed a SE of 0.83, a SP of 0.994, a LR+ of 132 (95% CI: 51-339) and a PPV of 0.50. In conclusion, the onset threshold of plasma levels of the sFlt-1/PlGF ratio was shown to be a highly sensitive and a highly specific screening method for detecting the imminent onset of PE within 4 weeks after blood sampling at 19-31 weeks.
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Hemodynamic pulmonary arterial hypertension (HPAH) is a common symptom in congenital heart disease (CHD) patients with a left-to-right shunt. Endothelial NO synthase (eNOS) and endothelial-like progenitor cells result in significant improvement of right ventricular systolic pressure in established pulmonary arterial hypertension (PAH) models. We hypothesized that bone marrow (BM)-derived endothelial progenitor cells (EPCs) and eNOS would prevent HPAH in a newly established rat model. ⋯ Two weeks after transplantation, the systolic pulmonary arterial blood pressure (sPAP) was significantly reduced by heNOS-EPCs treatment and by transplantation of control EPCs. The high number of muscular pulmonary arteries and the thickness of the muscular coat characteristic of HPAH rats were clearly reversed or even restored to normal levels following transplantation of EPCs, particularly eNOS-EPCs. These findings indicate a critical role of eNOS in HPAH treatment and suggest that eNOS-transfected EPCs may provide an effective strategy for HPAH treatment in CHD patients.