Effect of Blood Pressure Variability on Right Ventricular Remodelling in Pregnant Women with Hypertensive disorders of pregnancy

Background: Hypertensive disorders of pregnancy increase maternal and cardiovascular risks, impacting heart remodelling and function. Blood pressure variability can alter heart structure, yet clinical impact remains underexplored. The aim of this study was to evaluate potential impact of blood pressure variability on right ventricular remodeling in pregnant women with hypertensive disorders of pregnancy.Methods: This observational comparative study included 17 patients with preeclampsia, 23 with gestational hypertension and 20 healthy pregnant women at Aswan University hospital. Results: After three months, RV parameters remained significantly elevated in both hypertensive groups (P<0.0001), while RV strain parameters showed improvement but remained significantly lower (P<0.0001). Mean systolic and diastolic blood pressures were significantly correlated with RV dimensions and strain parameters in preeclampsia and gestational hypertension, with negative correlations observed for TAPSE and S'. In controls, mean diastolic blood pressure showed a significant negative correlation with S' (P=0.044). Maternal complications, including eclampsia (P=0.0184), preterm labor (P=0.015), and postpartum hemorrhage (P=0.0071), were significantly higher in preeclampsia. Conclusions: BP variability significantly affects RV remodeling in pregnant women with Pregnancy related hypertensive disorders. The persistence of elevated BP and RV abnormalities highlights the critical need for continued cardiovascular monitoring and management.