Pregnant women with autoimmune diseases had significantly reduced global work index (1756 vs. 1901 mmHg%, adjusted mean difference −223 mmHg%, p=0.005) and apical constructive work compared to healthy pregnant women, indicating subclinical left ventricular dysfunction despite preserved LVEF.
Cross-Sectional (n=96)
No
Does pregnancy in women with autoimmune diseases alter left ventricular myocardial work compared to healthy pregnancies or non-pregnant autoimmune patients?
Left ventricular myocardial work analysis, particularly apical constructive work, can detect subclinical left ventricular dysfunction in pregnant women with autoimmune diseases despite preserved ejection fraction.
Effect estimate: GWI difference approximately -145 mmHg% between AD-P and healthy pregnant women (95% CI GWI difference adjusted model B: −223.1 mmHg% (95% CI −374.4 to −71.9) vs. healthy pregnant women, p=0.005)
Absolute Event Rate: 1756% vs 1901%
p-value: p=0.005 adjusted for age, SBP, heart rate, multiparity
Purpose To quantitatively assess left ventricular (LV) myocardial work (MW) in pregnant women with autoimmune diseases (AD) using left ventricular pressure-strain loop (PSL) and explore its clinical implications. Methods Ninety-six participants were enrolled between September 2020 and September 2022 at the Affiliated Hospital of Inner Mongolia Medical University, including 33 pregnant women with AD (AD-P group), 26 non-pregnant AD patients (AD group), and 37 healthy pregnant women (H-P group). Clinical data, conventional echocardiography, two-dimensional speckle-tracking, and LV-MW analyses were obtained. Group comparisons and correlations between baseline characteristics and MW parameters were analyzed. Analysis of covariance (ANCOVA) and partial correlation were used for adjusted comparisons and associations. Results Following adjustment, the AD-P group demonstrated increased LV volume and lower apical constructive work (CW) compared to the AD group, while global MW indices were similar. Compared with H-P group, AD-P patients had lower E/A, increased LV volumes, E/e’, and peak strain dispersion (PSD). After adjustment, AD-P had reduced global work index (GWI), global constructive work (GCW), global work efficiency (GWE), and apical-CW, while PSD remained higher. Conclusion LV myocardial work detected subclinical LV dysfunction in pregnant women with autoimmune disease. Apical-CW showed a consistent reduction in AD-P. These findings suggest that myocardial work, especially apical CW, provides incremental value over global longitudinal strain (GLS) in autoimmune pregnancies.
Zhang et al. (Fri,) conducted a cross-sectional in Pregnant women in second trimester with autoimmune diseases (n=96). Pregnancy in women with autoimmune diseases vs. Non-pregnant women with autoimmune diseases and healthy pregnant women was evaluated on Left ventricular myocardial work assessed by left ventricular pressure-strain loop analysis, including global work index (GWI), global constructive work (GCW), global wasted work (GWW), global work efficiency (GWE), and apical constructive work (apical-CW) (GWI difference approximately -145 mmHg% between AD-P and healthy pregnant women, 95% CI GWI difference adjusted model B: −223.1 mmHg% (95% CI −374.4 to −71.9) vs. healthy pregnant women, p=0.005, p=p=0.005 adjusted for age, SBP, heart rate, multiparity). Pregnant women with autoimmune diseases had significantly reduced global work index (1756 vs. 1901 mmHg%, adjusted mean difference −223 mmHg%, p=0.005) and apical constructive work compared to healthy pregnant women, indicating subclinical left ventricular dysfunction despite preserved LVEF.