Severe pre-eclampsia was associated with higher right ventricular systolic pressure (31.0 vs 22.5 mm Hg; p<0.001) and decreased global right ventricular longitudinal systolic strain.
Observational (n=99)
Does severe pre-eclampsia alter short-term echocardiographic parameters compared to healthy pregnancy?
Severe pre-eclampsia is associated with significant acute subclinical cardiac dysfunction, including elevated right ventricular systolic pressure, decreased right ventricular strain, and left-sided chamber remodeling.
Absolute Event Rate: 31% vs 22.5%
p-value: p=<0.001
BACKGROUND Pre-eclampsia with severe features (PEC) is a pregnancy-specific syndrome characterized by severe hypertension and end-organ dysfunction, and is associated with short-term adverse cardiovascular events, including heart failure, pulmonary edema, and stroke. OBJECTIVES The authors aimed to characterize the short-term echocardiographic, clinical, and laboratory changes in women with PEC, focusing on right ventricular (RV) systolic pressure (RVSP) and echocardiographic-derived diastolic, systolic, and speckle tracking parameters. METHODS In this prospective observational study, the authors recruited 63 women with PEC and 36 pregnant control patients. RESULTS The PEC cohort had higher RVSP (31.0 ± 7.9 mm Hg vs. 22.5 ± 6.1 mm Hg; p < 0.001) and decreased global RV longitudinal systolic strain (RVLSS) (−19.6 ± 3.2% vs. −23.8 ± 2.9% p < 0.0001) when compared with the control cohort. For left-sided cardiac parameters, there were differences (p < 0.001) in mitral septal e′ velocity (9.6 ± 2.4 cm/s vs. 11.6 ± 1.9 cm/s), septal E/e′ ratio (10.8 ± 2.8 vs. 7.4 ± 1.6), left atrial area size (20.1 ± 3.8 cm2 vs. 17.3 ± 2.9 cm2), and posterior and septal wall thickness (median interquartile range: 1.0 cm 0.9 to 1.1 cm vs. 0.8 cm 0.7 to 0.9 cm, and 1.0 cm 0.8 to 1.2 cm vs. 0.8 cm 0.7 to 0.9 cm). Eight women (12.7%) with PEC had grade II diastolic dysfunction, and 6 women (9.5%) had peripartum pulmonary edema. CONCLUSIONS Women with PEC have higher RVSP, higher rates of abnormal diastolic function, decreased global RVLSS, increased left-sided chamber remodeling, and higher rates of peripartum pulmonary edema, when compared with healthy pregnant women.
“The damage done to the heart's pumping ability during pregnancy in women with preeclampsia is striking, and it makes sense that this particular kind of damage puts them at greater risk of heart disease and strokes in the future.”
Vaught et al. (Mon,) conducted a observational in Pre-eclampsia with severe features (n=99). Pre-eclampsia with severe features vs. Healthy pregnant controls was evaluated on Right ventricular systolic pressure (RVSP) (p=<0.001). Severe pre-eclampsia was associated with higher right ventricular systolic pressure (31.0 vs 22.5 mm Hg; p<0.001) and decreased global right ventricular longitudinal systolic strain.