Key result
Severe pre-eclampsia is linked to ~9 mm Hg higher RVSP and decreased global RV strain.
Why the study?
Pre-eclampsia with severe features is associated with short-term adverse cardiovascular events, but the short-term echocardiographic, clinical, and laboratory changes required further characterization.
Does severe pre-eclampsia alter short-term echocardiographic parameters compared to healthy pregnancy?
Observational (n=99)
Does severe pre-eclampsia alter short-term echocardiographic parameters compared to healthy pregnancy?
Severe pre-eclampsia is associated with significant acute subclinical cardiac dysfunction, including elevated right ventricular systolic pressure, decreased right ventricular strain, and left-sided chamber remodeling.
Answers are grounded in this paper and cite their sources.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“A thicker, larger heart shows that the heart is working harder than normal. It gets bigger like the body's muscles when you work out, but in this case it isn't a good thing, and it's a serious risk factor for heart failure.”
“The damage done to the heart's pumping ability during pregnancy in women with preeclampsia is striking, and it makes sense that this particular kind of damage puts them at greater risk of heart disease and strokes in the future.”
“It supports the concept that pregnancy should be valued as a sex-specific, women-sensitive CV stress test, and the necessity to use novel methods in order to detect early stage abnormalities in the twilight zone between health and disease.”
Acute RV pressure elevation with reduced strain in severe pre-eclampsia signals subclinical dysfunction; observational data leave open long-term CV risk prediction.
BACKGROUND Pre-eclampsia with severe features (PEC) is a pregnancy-specific syndrome characterized by severe hypertension and end-organ dysfunction, and is associated with short-term adverse cardiovascular events, including heart failure, pulmonary edema, and stroke. OBJECTIVES The authors aimed to characterize the short-term echocardiographic, clinical, and laboratory changes in women with PEC, focusing on right ventricular (RV) systolic pressure (RVSP) and echocardiographic-derived diastolic, systolic, and speckle tracking parameters. METHODS In this prospective observational study, the authors recruited 63 women with PEC and 36 pregnant control patients. RESULTS The PEC cohort had higher RVSP (31.0 ± 7.9 mm Hg vs. 22.5 ± 6.1 mm Hg; p < 0.001) and decreased global RV longitudinal systolic strain (RVLSS) (−19.6 ± 3.2% vs. −23.8 ± 2.9% [p < 0.0001]) when compared with the control cohort. For left-sided cardiac parameters, there were differences (p < 0.001) in mitral septal e′ velocity (9.6 ± 2.4 cm/s vs. 11.6 ± 1.9 cm/s), septal E/e′ ratio (10.8 ± 2.8 vs. 7.4 ± 1.6), left atrial area size (20.1 ± 3.8 cm2 vs. 17.3 ± 2.9 cm2), and posterior and septal wall thickness (median [interquartile range]: 1.0 cm [0.9 to 1.1 cm] vs. 0.8 cm [0.7 to 0.9 cm], and 1.0 cm [0.8 to 1.2 cm] vs. 0.8 cm [0.7 to 0.9 cm]). Eight women (12.7%) with PEC had grade II diastolic dysfunction, and 6 women (9.5%) had peripartum pulmonary edema. CONCLUSIONS Women with PEC have higher RVSP, higher rates of abnormal diastolic function, decreased global RVLSS, increased left-sided chamber remodeling, and higher rates of peripartum pulmonary edema, when compared with healthy pregnant women.
No takes yet. Share an insight, caveat, or question.
Vaught et al. (2018) conducted an observational in Pre-eclampsia with severe features (n=99). Pre-eclampsia with severe features vs. Healthy pregnant controls was evaluated on Right ventricular systolic pressure (RVSP) (p=<0.001). Severe pre-eclampsia was associated with higher right ventricular systolic pressure (31.0 vs 22.5 mm Hg; p<0.001) and decreased global right ventricular longitudinal systolic strain.
Synapse has enriched 10 related papers. Consider them for comparative context: