Multiparametric Assessment of Maternal Vascular Function in the Prediction of Hypertensive Disorders of Pregnancy

NCT ID: NCT05999851

Last Updated: 2026-01-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

400 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-09-01

Study Completion Date

2031-09-30

Brief Summary

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The present study is a single-centre prospective study that will enrol pregnant women during their first trimester of pregnancy (11+0 - 13+6 weeks of gestation).

During pregnancy, women will undergo standard clinical evaluation and management. During the two study visits (enrollment and 24+0 - 27+6 weeks of gestation) the investigators will perform arterial tonometry (Pulsepen) and in vivo darkfield microscopy (Glycocheck) to evaluate endothelial and vascular function. A urine sample and a blood sample for specific study analyses on metabolic profile, endothelial and angiogenic markers will be collected. Pregnancy outcomes will be collected at delivery and five years after delivery all the participants will be interview to collect long-term cardiovascular outcomes. Serum endothelial and angiogenic markers will be evaluated only in participants who will develop hypertensive disorders of pregnancy and in an equal number of controls matched for age and body mass index at the time of conception.

Detailed Description

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Primary aim:

To determine the role of the combination of arterial tonometry and endothelial glycocalyx measurement in predicting the risk of developing hypertensive disorders in pregnancy.

Secondary aims:

* To determine the association between circulating markers of angiogenesis and endothelial dysfunction (ANG-1, ANG-2, ET-1, ICAM-1 and VCAM-1) and the development of hypertensive disorders of pregnancy.
* To define the trends of serum uric acid, lipids and xanthine oxidase activity in normotensive and hypertensive pregnancies.
* To determine the ability of the combination of arterial tonometry and endothelial glycocalyx measurement, performed in the two study visits during pregnancy, in predicting the risk of long-term maternal cardiovascular disease.

Conditions

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Preeclampsia Hypertensive Disorder of Pregnancy

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

The study is a single group study (Principal Arm) with a sub-group of participants undergoing additional experimental analyses. The additional analyses will be performed in participants who will develop hypertensive disorders of pregnancy and matched (age and body mass index before conception) controls with healthy pregnancies.
Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Principal arm

The entire cohort of participants will undergo all experimental procedures. Participants who will develop hypertensive disorders of pregnancy and matched participants with healthy pregnancies will also undergo serum endothelial and angiogenic markers assessment.

Group Type EXPERIMENTAL

Arterial applanation tonometry

Intervention Type DEVICE

Arterial applanation tonometry will be performed at the carotid and femoral level by the PulsePen device (Software WPulsePen version 2.3.1, DiaTecne, Milan, Italy), while the subject is lying in the horizontal position and after 5 minutes of rest.

In vivo endothelial glycocalyx measurement

Intervention Type DEVICE

The in vivo microscopy (GlycoCheck system) is performed in the sublingual capillaries during the morning, with the participant sitting on a chair. The sublingual capillaries are visualized using an SDF video microscope (Capiscope handheld, KK Research technology Ltd).

Serum markers of angiogenesis and endothelial dysfunction

Intervention Type DIAGNOSTIC_TEST

ELISA assays to measure serum circulating markers of angiogenesis and endothelial dysfunction (ANG-1, ANG-2, ET-1, ICAM-1 and VCAM-1).

Blood chemistry test

Intervention Type DIAGNOSTIC_TEST

Immunochemistry analysis of serum levels of uric acid, total cholesterol, LDL-cholesterol, HDL-cholesterol, Triglycerides, Lipoprotein (a)

Serum xanthine oxidase activity

Intervention Type DIAGNOSTIC_TEST

Serum xanthine oxidase (XO) activity will be assessed in blood samples measuring the ability of XO to produce uric acid

Interventions

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Arterial applanation tonometry

Arterial applanation tonometry will be performed at the carotid and femoral level by the PulsePen device (Software WPulsePen version 2.3.1, DiaTecne, Milan, Italy), while the subject is lying in the horizontal position and after 5 minutes of rest.

Intervention Type DEVICE

In vivo endothelial glycocalyx measurement

The in vivo microscopy (GlycoCheck system) is performed in the sublingual capillaries during the morning, with the participant sitting on a chair. The sublingual capillaries are visualized using an SDF video microscope (Capiscope handheld, KK Research technology Ltd).

Intervention Type DEVICE

Serum markers of angiogenesis and endothelial dysfunction

ELISA assays to measure serum circulating markers of angiogenesis and endothelial dysfunction (ANG-1, ANG-2, ET-1, ICAM-1 and VCAM-1).

Intervention Type DIAGNOSTIC_TEST

Blood chemistry test

Immunochemistry analysis of serum levels of uric acid, total cholesterol, LDL-cholesterol, HDL-cholesterol, Triglycerides, Lipoprotein (a)

Intervention Type DIAGNOSTIC_TEST

Serum xanthine oxidase activity

Serum xanthine oxidase (XO) activity will be assessed in blood samples measuring the ability of XO to produce uric acid

Intervention Type DIAGNOSTIC_TEST

Other Intervention Names

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PulsePen Arterial stiffness measurement Pulse wave velocity assessment Glycocheck Sidestream dark field microscopy ANG-1 ET-1 ICAM-1 VCAM-1 ANG-2

Eligibility Criteria

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Inclusion Criteria

* Age greater than or equal to 18 years
* Single pregnancy
* No previous pregnancies lasting more than 12 weeks
* Participant willing and able to give informed consent for participation in the study

Exclusion Criteria

* Intermediate-high risk of genetic abnormalities and/or need to perform invasive tests (amniocentesis, villocentesis)
* History of solid organ or hematopoietic stem cell transplantation
* Chronic renal failure (eGFR≤45ml/min/1.73m2)
* Chronic treatment with antihypertensive drugs and/or xanthine oxidase (XO) inhibitors
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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University of Bologna

OTHER

Sponsor Role collaborator

IRCCS Azienda Ospedaliero-Universitaria di Bologna

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Arrigo Francesco Giuseppe Cicero, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

IRCCS University Hospital of Bologna, Italy. University of Bologna, Italy.

Locations

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Cardiovascular Internal Medicine Unit, IRCCS University Hospital of Bologna, Bologna, Italy

Bologna, , Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Arrigo Francesco Giuseppe Cicero, MD, PhD

Role: CONTACT

+39 051 214290

Cristina Scollo, BD

Role: CONTACT

Facility Contacts

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Arrigo Francesco Giuseppe Cicero, MD, PhD

Role: primary

+39051214290

Other Identifiers

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346/2023/Oss/AOUBo

Identifier Type: -

Identifier Source: org_study_id

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