Estimation of Left Ventricular Diastolic Function in Gestational Hypertension during the Third Trimester Inbaghdad Teaching Hospital

Background: Gestational hypertension exerts a great challenge on the maternal cardiovascular system, in spite of this fact, there is lack of reports regarding the maternal diastolic function in gestational hypertension which precedes systolic dysfunction in any cardiovascular complications. Objectives: To evaluate the maternal left ventricular diastolic function in gestational hypertensive women in the third trimester by measuring the mitral inflow parameters with pulse wave Doppler and Tissue Doppler Imaging. Patients and Methods: This studywas conducted in Baghdad teaching hospital from November 2015 to June 2016. Sixty gestational hypertensive womenwith singleton pregnancy in the third trimester, aged 29.7 5.9 year, gestational hypertension was defined as systolicblood pressure that is equal or more than 140 mmHg or diastolic bloodpressurethatequals or exceeds 90 mmHg and starts after 20 weeks of gestation without proteinuria were enrolled in this study. Another 50 Normal pregnant womenaged 28 3.18year served as controls. The left ventricular diastolic function was studied using two transthoracic echocardiographic methods: Pulsed wave Doppler (PWD) to measure the transmitral flow velocity including the early maximum velocity of mitral inflow(E wave), the late maximum velocity of mitral inflow (A wave), and E/A ratio was recorded. Tissue Doppler imaging (TDI) to measure thelateralmitral annular velocity (lateral ), the septal mitral annular velocity (septal ) and their average () was calculated. The ratio of E/ was recorded. Results: Gestational hypertensive women hadsignificant lower E wave velocity compared tonormal pregnant women (P value was 0.001). "A"wave velocity was higher in gestational hypertensive women with statistical difference(P value 0.002) and E/A was significant low in gestational hypertension with P value <0.05. Tissue Doppler imaging showed significant difference in velocity which was lowerin gestational hypertensive women (P value 0.001). E/in gestational hypertension showed significantly higher value than controls with P value<0.05. Conclusion: Gestational hypertension puts the maternal heart under pressure and volume overload associated with impaired relaxation as manifested by the changes inthe left ventricular diastolic function measured by transthoracic echocardiography.