Author + information
- Livia Florentina Trasca,
- Natalia Patrascu,
- Diana Mihalcea,
- Laura Lungeanu,
- Sorina Mihaila,
- Ramona Bruja,
- Manuela Neagu,
- Monica Cirstoiu,
- Simona Albu and
- Dragos Vinereanu
Background: Gestational hypertension (GHT) and preeclampsia (PE) are associated with a significant and early cardiovascular risk, however effect of these conditions on cardiac function is insufficiently studied.
Methods: We performed a very detailed echo study to evaluate subclinical changes of cardiac function in pregnant women diagnosed with GHT or PE, after the 20th week of pregnancy, compared to matched normotensive controls. 58 pregnant women were studied: 30 with GHT (18) or PE (12), without other cardiac diseases, and 28 normotensives, as control. Left ventricular (LV) global systolic function was assessed by 4D LV ejection fraction (EF); LV longitudinal systolic function by tissue Doppler S wave; and LV diastolic function by multiple spectral and tissue Doppler parameters. Left atrial (LA) function was assessed by volumetric measurement of total, passive, and active emptying fractions.
Results: There were no significant differences between GHT/PE and control groups regarding age (32±5 vs. 31±3 years), pregnancy weeks, primi-/multiparity status, and heart rate (89±12 vs. 85±10 bpm). GHT/PE group vs. controls had higher BP (159±25/103±31 vs. 109±12/65±9 mmHg), higher pre-pregnancy body mass index (25.9±5.0 vs. 22.3±2.0 kg/m2), and important weight gain during pregnancy (11.5±6.0 vs. 8.5±3.0 kg) (all p<0.05). Both LV global and longitudinal systolic functions were decreased significantly in GHT/PE group: EF 52.8±5.0% vs. 58.1±6.0% and S wave 10.2±2.0 vs. 12.7±2.0 cm/s (both p<0.01); as well as LV global and longitudinal diastolic functions: E/A 1.2±0.2 vs. 1.4±0.3, Vp 57.2±16.0 vs. 71.7±15.0 cm/s, IVRT 88±16 vs. 72±14 ms, E’ 12.6±2.0 vs. 15.6±3.0 cm/s (all p<0.05). Meanwhile, LA total and passive emptying fractions were significantly lower in GHT/PE group 68±8% vs. 74±7% and 40±10% vs. 51±10% (both p<0.01). There were no significant differences between the two subgroups, GHT and PE pregnant women.
Conclusions: Both GHT and PE are equally associated with subclinical LV systolic and diastolic dysfunction. Whether this condition is transitory or it persists after discharge, increasing risk to progression to heart failure, should be established in future studies.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Novel Imaging and Therapies in Heart Failure
Abstract Category: 12. Heart Failure and Cardiomyopathies: Basic
Presentation Number: 1200-257
- 2017 American College of Cardiology Foundation