Key result
Normotensive and preeclamptic pregnancies were associated with increased left ventricular mass (76 and 90 g/m2, respectively, vs 65 g/m2 in controls; P<0.05) but preserved LV contractility.
Why the study?
Does normotensive or preeclamptic pregnancy alter left ventricular geometry and contractility compared to nonpregnant controls?
Observational (n=71)
Does normotensive or preeclamptic pregnancy alter left ventricular geometry and contractility compared to nonpregnant controls?
LV hypertrophy in both normotensive and preeclamptic pregnancies appropriately matches changes in cardiac work without reducing intrinsic LV contractility.
Supports adaptive LV remodeling in pregnancy without contractility loss; leaves open long-term CV risk implications.
Increased cardiac output in pregnancy is associated with cardiac remodeling and possible reduction in contractility, which may worsen in preeclampsia. Left ventricular (LV) geometry and function were compared between nonpregnant controls (n = 12) and normotensive (n = 44) and preeclamptic (n = 15) pregnant women using echocardiography. Load-independent comparisons of LV systolic function compared end-systolic stress (ESS) and rate-corrected velocity of circumferential fiber shortening (V(CFC)). Mean arterial pressures were 101 +/- 14 mmHg in preeclampsia, 76 +/- 6 mmHg in normotensive pregnancy, and 78 +/- 6 mmHg in controls (P < 0.005 vs. preeclampsia). LV mass increased during normotensive pregnancy (66 +/- 13 to 76 +/- 16 g/m(2); P < 0.05; controls, 65 +/- 10 g/m(2); P < 0.05) and was greater in preeclampsia (90 +/- 18 g/m(2); P < 0.05). In normotensive pregnancy, ESS decreased (59 +/- 9 to 52 +/- 11 g/cm(2); P < 0.05; controls, 66 +/- 14 g/cm(2); P < 0.005). ESS was greater in preeclampsia (60 +/- 14 g/cm(2); P < 0.05). In controls, there was an inverse relationship between ESS and V(CFC) (r = -0.78). The ESS-V(CFC) relationships in normotensive and preeclamptic pregnancy were unchanged from controls. We conclude that LV hypertrophy in normotensive and preeclamptic pregnancy matches changes in cardiac work, and LV contractility is preserved.
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Simmons et al. (2002) conducted an observational in Preeclampsia and normotensive pregnancy (n=71). Normotensive and preeclamptic pregnancy vs. Nonpregnant controls was evaluated on Left ventricular geometry and systolic function (LV mass, end-systolic stress, and V(CFC)). Normotensive and preeclamptic pregnancies were associated with increased left ventricular mass (76 and 90 g/m2, respectively, vs 65 g/m2 in controls; P<0.05) but preserved LV contractility.
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