Long-term reduction of endothelial glycocalyx thickness 6 years after preeclampsia

Objective. The endothelial glycocalyx (EG) is a complex struc­ture composed of proteoglycans, glycoproteins, and glycolip­ids that extends from the surface of endothelial cells into the vascular lumen. It plays a critical role in maintaining homeo­stasis by acting as a barrier, regulating vascular permeability, and influencing various signalling pathways.
In the present study we aimed to evaluate EG thickness in women after a pregnancy complicated by preeclampsia (PE) vs those with a healthy pregnancy.
Materials and Methods. Sublingual capillaries were evalu­ated in vivo by side stream dark field microscopy. Eighteen women with previous normotensive pregnancies and 31 with PE on average 6 years after their index pregnancy participat­ed in the study. The width of the EG permeable to red blood cells (PBR) as a measure of EG thickness and the percentage of vessels filled with red blood cells ≥ 50% of the time indicating actual microvascular perfusion, were calculated.
Results. Women who suffered from PE had a significantly increased global PBR value (3.35 vs 3.02 micron, p = 0.031), suggesting a reduced EG thickness. No significant differences were observed concerning microvascular perfusion, although a trend towards a decreased perfusion was observed in wom­en with PE.
Conclusions. EG is implicated in the regulation of vascular permeability and inflammation. These factors have been im­plicated in the pathogenesis of PE. Disruption of the EG could contribute to abnormal placental perfusion with the release of factors that may contribute to the development and progres­sion of PE. EG impairment may persist years after pregnancy, leading to long-term cardiovascular complications.