Association of peripartum troponin I levels with left ventricular relaxation in women with hypertensive disorders of pregnancy

Figures

• 

  Figure 1. Representative echocardiographic findings: women with HDP versus women with NCP. †P<0.05 between the two groups. Vertical bars indicate ±SE. bpm, beats per minute; e', average of early diastolic septal and lateral mitral annular velocity; E/A, ratio of early to late diastolic transmitral flow velocity; E/e', ratio of early diastolic mitral flow velocity to e'; HDP, hypertensive disorders of pregnancy; IVC, inferior vena cava; LA, left atrial; LV, left ventricular; LVDd, LV end-diastolic dimension; NCP, normotensive control pregnancy; PP1, immediately postpartum within 1 week after childbirth; PP2, approximately 1 month postpartum; s', average of systolic septal and lateral mitral annular velocity; S/D, ratio of systolic pulmonary venous flow velocity to anterograde diastolic pulmonary venous flow velocity; SVR, systemic vascular resistance.

• 

  Figure 2. Changes in blood biomarker levels during pregnancy/postpartum. †P<0.05 between the two groups. Vertical bars indicate 25th–75th percentile values. Data on BNP were determined in a limited number of women (see footnote for table 2). BNP, brain natriuretic peptide; HDP, hypertensive disorders of pregnancy; eGFR, estimated glomerular filtration rate; hs-TnI, high-sensitivity troponin I; NCP, normotensive control pregnancy; NT-proBNP, N-terminal pro–B-type natriuretic peptide; PP1, immediately postpartum within 1 week after childbirth; PP2, approximately 1 month postpartum.

• 

  Figure 3. Standardised regression coefficients between blood variable levels and echocardiographic measurements. All data on biomarkers and five echocardiographic parameters determined simultaneously in 24 women with HDP and 51 women with NCP were used for this analysis. β, standardised regression coefficient. The regression line was drawn for β>0.25 or <–0.25. When hs-TnI level was below the limit of detection (0.1 pg/mL), we assumed that hs-TnI was present at a serum concentration of 0.1 pg/mL. BNP, brain natriuretic peptide; e', average of early diastolic septal and lateral mitral annular velocity; eGFR, estimated glomerular filtration rate; HDP, hypertensive disorders of pregnancy; hs-TnI, high-sensitivity troponin I; LA, left atrial; LV, left ventricular; LVDd, LV end-diastolic dimension; LVEF, LV ejection fraction; NCP, normotensive control pregnancy; NT-proBNP, N-terminal pro–B-type natriuretic peptide.

• 

  Figure 4. Associations of peripartum biomarker levels with e' at 1 month postpartum (PP2). BNP, brain natriuretic peptide; e', average of early diastolic septal and lateral mitral annular velocity; eGFR, estimated glomerular filtration rate; hs-TnI, high-sensitivity troponin I; NT-proBNP, N-terminal pro–B-type natriuretic peptide; PP1, immediately postpartum within 1 week after childbirth.

• 

  Figure 5. Receiver operating characteristic curves of hs-TnI at third trimester and immediately postpartum in the prediction of reduced e' (< 7.7 cm/s) at 1 month postpartum. The e' of 7.7 cm/s corresponded to the fifth percentile value of 51 women with normotensive control pregnancy at 1 month postpartum. AUC, area under the curve; e', average of early diastolic septal and lateral mitral annular velocity; hs-TnI, high-sensitivity troponin I.