Key result
Pre-eclampsia is linked to increased LA volume and LV mass index but unchanged LVEF.
Why the study?
Pre-eclampsia may cause adverse outcomes due to cardiac impairment if untreated, prompting investigation into its association with cardiac structure and function.
Does pre-eclampsia alter cardiac structure and function in pregnant women compared to non-pre-eclamptic women?
Meta-Analysis (n=12,634)
Does pre-eclampsia alter cardiac structure and function in pregnant women compared to non-pre-eclamptic women?
Standardized Mean Difference: 0.7 (95% CI 0.43–0.96)
p-value: p=<0.001
Pre-eclampsia is associated with significant adverse cardiac remodeling, including left atrial dilation and increased left ventricular mass, despite preserved ejection fraction.
May warrant closer echocardiographic monitoring in pre-eclampsia; extends observational evidence of remodeling with preserved EF but requires prospective validation.
Introduction Pre-eclampsia (PreE), presenting after the 20th week of gestation, leads to high blood pressure and proteinuria. If left untreated it may cause adverse outcomes due to cardiac impairment. Objective The current meta-analysis sought to investigate the association of PreE with cardiac structure and function. Methodology A systematic review was conducted in electronic databases to identify studies reporting the association of PreE with the structure and function of the heart in comparison with non-PreE women. Results Fourteen studies with 12,634 patients were included in the meta-analysis. Women with PreE were older (standardized mean difference (SMD) = 0.12, 95% confidence interval (CI) =0.04-0.20, p <0.003, I2 =1.29%), and with greater body mass index (SMD =0.46, 95% CI =0.39-0.52, p <0.001, I2 =0.05%) compared with non-PreE. The patients with PreE had more dilated left atrial (LA) volume in comparison to the non-PreE group (SMD =0.70, 95% CI =0.43-0.96, p <0.001, I2 =0%) and LA Volume Index (SMD =0.46, 95% CI =0.25-0.67, p <0.001, I2 =10.01%). Moreover, the left ventricular (LV) end-diastolic diameter (SMD =0.22, 95% CI =0.07-0.37, p =0.004, I2 =0%), the LV posterior wall thickness (SMD =1.42, 95% CI =1.12-1.73, p <0.001, I2 =0%), the interventricular septum thickness (SMD =0.83, 95% CI =0.68-0.98, p <0.001, I2 =0%) and the LV mass index (SMD =0.62, 95% CI =0.48-0.77, p <0.001, I2 =0.01%) were increased in PreE compared to the non-PreE women. Considering the cardiac function, there was no significant difference in the LV ejection fraction (SMD =0.03 , 95% CI =-0.21-0.27, p =0.798, I2 =0%) between the 2 groups. Conclusion Women with PreE have more pronounced cardiac remodelling and similar LV ejection fraction compared with their counterparts.
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Tsokkou et al. (2026) conducted a meta-analysis in Pre-eclampsia (n=12,634). Pre-eclampsia vs. Non-preeclamptic women was evaluated on Left atrial (LA) volume (SMD 0.70, 95% CI 0.43-0.96, p=<0.001). Pre-eclampsia was associated with more pronounced cardiac remodeling, including increased left atrial volume (SMD 0.70; 95% CI 0.43-0.96; p<0.001), compared with non-preeclamptic pregnant women.
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