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July 9, 2025BMC Pregnancy and ChildbirthOpen Access

Early cardiovascular changes in hypertensive pregnancies: insights from left atrial strain and compliance

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Why the study?

Hypertensive disorders of pregnancy can cause subclinical cardiac dysfunction, but traditional echocardiographic parameters often fail to detect early myocardial and atrial abnormalities.

Do pregnant women with hypertensive disorders exhibit impaired left atrial strain and compliance compared to normotensive pregnancies?

Population

73 pregnant women from 20 weeks of gestation onward (38 with HDP, 35 normotensive)

Comparison

Hypertensive disorders of pregnancy vs normotensive pregnancies

Design

Prospective observational study

Key result

Hypertensive disorders of pregnancy were associated with significantly reduced left atrial compliance compared to normotensive pregnancies, serving as an independent predictor of the condition (OR 0.50).

Authors

TMTatjana MaselienėALA. LaurinavicieneVDV. Dženkevičiūtė

Discussion

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Overview

LA strain/compliance detect subclinical dysfunction in HDP despite preserved EF; leaves open their utility for routine risk stratification.

Study Design

Type

Case-Control (n=73)

Blinding

Single-blind

Multicenter

No

Structured PICO

Do pregnant women with hypertensive disorders exhibit impaired left atrial strain and compliance compared to normotensive pregnancies?

P
Population
73 pregnant women (38 with hypertensive disorders of pregnancy and 35 normotensive controls) from 20 weeks of gestation onward, evaluated for early subclinical cardiac dysfunction.
C
Comparator
Normotensive pregnancies (n=35)
O
Outcome
Left atrial (LA) strain (reservoir, conduit, contraction), LA compliance (LASr/E/e'), and global longitudinal strain (GLS) assessed through speckle-tracking echocardiographysurrogate

Main Result

Odds Ratio: 0.5 (95% CI 0.33–0.76)

Absolute Event Rate: 3.87% vs 5.57%

p-value: p=0.001

Advanced echocardiographic parameters, specifically left atrial strain and compliance, can detect early subclinical cardiac dysfunction in pregnant women with hypertensive disorders despite preserved ejection fraction.

Limitations

  • Small size of some subgroups, particularly those with gestational hypertension
  • Single center study reduces generalizability
  • Observational, cross-sectional design prevents conclusions about causality
  • Lack of postnatal follow-up or perinatal outcomes
  • Broad gestational age range (20-38 weeks) may have influenced left atrial size and function
  • Early pharmacological intervention may have influenced strain or compliance values

Cite This Study

Maselienė et al. (2025) conducted a case-control in Hypertensive disorders of pregnancy (n=73). Hypertensive disorders of pregnancy vs. Normotensive pregnancies was evaluated on Left atrial compliance (LASr/E/e′) (OR 0.50, 95% CI 0.33-0.76, p=0.001). Hypertensive disorders of pregnancy were associated with significantly reduced left atrial compliance compared to normotensive pregnancies, serving as an independent predictor of the condition (OR 0.50).

synapsesocial.com/papers/6a96b41c61dfe9432d02027fhttps://doi.org/10.1186/s12884-025-07857-w
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