Igor Trifunovic
Pronouns: he/him
Research Mentor(s): Abbi Lane
Research Mentor School/College/Department: Applied Exercise Science / Kinesiology
Program:
Authors: Igor Trifunovic, Marnie McLean, Abbi Lane
Session: Session 4: 1:40 pm – 2:30 pm
Poster: 2
Abstract
Pregnancy complications such as preeclampsia, preterm birth, and placental problems are associated with a higher risk of future pathology, including cardiovascular disease (CVD). The Hemodynamics After Adverse Pregnancy Outcomes Study (HAAPO) is an ongoing investigation into the pathway linking adverse pregnancy outcomes (APOs) and changes in arterial stiffness and wave reflection—two potential indicators of CVD risk. Arterial stiffening is a physiological adaptation associated with advancing age and vascular dysfunction. Arterial wave reflection is a measurement of blood pressure waves’ reflected backflow at vascular bifurcations or walls, directly influencing left ventricular workload. Arterial stiffening may present as an increase in systolic blood pressure, a decrease in diastolic blood pressure, or subclinically as an increase in the velocity at which pressure waves travel through the arteries. Pulse wave velocity and central aortic waveforms, together denoting arterial stiffness and wave reflection, can be measured noninvasively. An anticipated 1,430 formerly pregnant women across six sites participating in the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be Heart Health Study 2 (nuMoM2b-HHS2) will have their arterial stiffness and vascular function measured to test the hypothesis that those who experienced APOs will have higher (worse) arterial stiffness and wave reflection. With the launch of data collection in February 2024, mass data is not yet available and no conclusions can be definitively drawn; however, the positive correlation between APOs and arterial stiffness is predicted because of unfavorable pathophysiological processes described after APOs and worse lifestyle behaviors that are common risk factors for both outcomes. As the increased cardiac workload caused by arterial stiffness might be a pertinent step in the pathogenesis of subclinical CVD, examining the association of APOs and timing of multiple modifiable behaviors with markers of subclinical CVD risk will help inform the proper timeline and targets for CVD prevention in the 20% of pregnant women expected to experience an APO each year.
