Key result
Hypertensive pregnancy exposure is linked to ~41% lower LV end-diastolic kinetic energy in children.
Why the study?
Hypertensive pregnancies are linked to greater cardiovascular risk and subclinical cardiac changes in offspring, prompting investigation into whether exposed children exhibit altered left ventricular morphology and cardiac flow characteristics.
Does exposure to hypertensive pregnancy alter left ventricular morphology and cardiac flow characteristics in children aged 6-9 years?
Cross-Sectional (n=100)
Blinded image analysis
No
Does exposure to hypertensive pregnancy alter left ventricular morphology and cardiac flow characteristics in children aged 6-9 years?
Absolute Event Rate: 3.35% vs 5.7%
p-value: p=<0.001
Children born to hypertensive pregnancies exhibit subtle subclinical differences in left ventricular morphology and lower diastolic flow kinetic energy at age 6-9 years, suggesting early cardiovascular phenotypic changes.
Aims Hypertensive pregnancies affect up to 10% of pregnancies globally and are linked to greater cardiovascular risk in offspring. Subclinical cardiac changes have been reported across developmental stages. This study aimed to assess whether children born to hypertensive pregnancies exhibit altered left ventricular (LV) morphology and cardiac flow characteristics. Methods In this cross-sectional study, cardiovascular magnetic resonance (CMR) was performed on a 3.0-Tesla Siemens Prisma scanner in children aged 6–9 years: 44 offspring of hypertensive pregnancies (50% female) and 56 controls from normotensive pregnancies (37.5% female). Free-breathing real-time cine images were acquired to assess structure and function and to create a computational LV shape atlas. Four-dimensional (4D) Flow CMR was acquired to quantify LV flow component volumes and kinetic energy (KE), enabling assessment of intraventricular flow organisation and energetics. Results Children born to hypertensive and normotensive pregnancies were matched in age (7.49 ± 0.73 and 7.41 ± 1.12 years), but those from hypertensive pregnancies had significantly shorter gestations (median 37.3 weeks [IQR 35.6–39.0] vs. 39.0 weeks [37.7–40.8], P = 0.002). Conventional cardiac measures did not differ between groups. Exploratory shape analysis identified subtle group-level LV differences, including relative prominence of the basal anterior wall, and a more convex LV outflow tract (P < 0.01; AUC=0.654). LV retained inflow end-diastolic KE was lower in exposed offspring (3.35 [3.03–4.80] vs 5.70 [4.35–6.80] μJ/mL; P < 0.001). Conclusion Children born to hypertensive pregnancies show subtle group-level differences in LV morphology and diastolic flow energetics. These findings suggest early differences in cardiovascular phenotype, although their long-term clinical significance remains uncertain and requires longitudinal investigation.
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Sattwika et al. (2026) conducted a cross-sectional in Children born to hypertensive pregnancies (n=100). Hypertensive pregnancy vs. Normotensive pregnancy was evaluated on LV retained inflow end-diastolic kinetic energy (p=<0.001). Children born to hypertensive pregnancies exhibited lower left ventricular retained inflow end-diastolic kinetic energy compared to controls (3.35 vs 5.70 μJ/mL, p<0.001).
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