Key result
Pregnancy-induced hypertension is linked to early subclinical impairments in LV and LA myocardial strain.
Why the study?
The value of tissue doppler imaging combined with 4D myocardial strain parameters in evaluating left heart function in pregnant women with hypertensive disorders was unclear.
Does TDI combined with 4D myocardial strain parameters detect early changes in cardiac function in pregnant women with hypertensive disorders?
Cross-Sectional (n=75)
No
Does TDI combined with 4D myocardial strain parameters detect early changes in cardiac function in pregnant women with hypertensive disorders?
p-value: p=<0.05
Tissue Doppler imaging combined with 4D myocardial strain parameters can accurately detect subclinical left heart dysfunction in pregnant women with hypertensive disorders before overt structural or ejection fraction changes occur.
May support early strain imaging for subclinical dysfunction in PIH; hypothesis-generating pending prospective outcome studies.
This study aimed to investigate the value of tissue doppler imaging (TDI) and 4D myocardial strain parameters in evaluating left heart function of pregnant women with hypertension and the association between these parameters and relevant factors. Forty-five pregnant women with hypertensive disorder, including 20 with hypertension, 15 with mild preeclampsia, and 10 with severe preeclampsia, were recruited, and their cardiac functions were compared with those of 30 healthy pregnant women as controls. High Left ventricular end-systolic volume (LVESV), Left atrial volume index (LAVI), E/e were observed in hypertensive disorder, while Mitral peak diastolic velocity(E), Early diastolic peak velocity(e), E/A, Left ventricularglobal longitudinal strain (LVGLS), Left ventricularglobal area strain (LVGAS), and Left atrialglobal longitudinal strain (LAGLS) were decreased; for pre-eclampsia, Left ventricular end-systolic diameter (LVESD), Left atrial anteroposterior diameter (LAD-ap), LVESV, LAVI were significantly increased, LVGLS, LAGLS were significantly decreased, Left ventricular end-diastolic diameter (LVEDD), Left ventricular end-diastolic volume (LVEDV), A peak, E/e were increased, while E peak, E/A, e, Left ventricle global radial strain (LVGRS), Left ventricle global circumferential strain (LVGCS), LVGAS were decreased but not significantly; for severe preeclampsia, Left ventricular end diastolic diameter (LVEDD), LVESD, LAD-ap, Left ventricular end-diastolic volume (LVEDV), LVESV, LAVI, A, and E/e were significantly increased, while LVGLS, LVGRS, LVGCS, LVGAS, LAGLS, E peak, E/A, and e were significantly reduced. TDI combined with 4D myocardial strain parameters can detect early changes in cardiac function of hypertensive disorders in pregnancy, with LVGLS, LVGAS, and LAGLS being the most sensitive indicators for early changes. Such findings provide a basis for effective clinical treatment of these symptoms.
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Lin et al. (2023) conducted a cross-sectional in Pregnancy-induced hypertension (n=75). Pregnancy-induced hypertension vs. Healthy pregnant women was evaluated on Early changes in cardiac function evaluated by tissue Doppler imaging and 4D myocardial strain parameters (LVGLS, LVGAS, LAGLS) (p=<0.05). Pregnancy-induced hypertension was associated with significant early impairments in left ventricular global longitudinal strain, global area strain, and left atrial global longitudinal strain compared to healthy pregnancies.
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