Echocardiographic comparison of cardiac remodelling in preeclamptic versus normotensive pregnancies

Introduction: Pregnancy is associated with multiple cardiovascular adaptative processes. Even in normal pregnancies, along with functional adaptive processes, a certain degree of structural cardiac remodelling developes.
Objective: Our study analysed impact of preeclampsia on left ventricular function and geometric remodeling patterns, in comparison with normal pregnancies, using echocardiography.
Methods: We analyzed data from clinical exams and echocardiograms performed in 68 pregnant women, 38 normotensives and 30 with preeclampsia, diagno-sed according to International Society for the Study of Hypertension in Pregnancy (ISSHP) 2013 criteria. The interventricular septum and the left ventricular posterior wall thickness were measured in the paras-ternal long-axis incidence. Left ventricular mass and relative wall thickness were calculated according to Devereaux’s formula, and patterns of left ventricular remodelling were considered according to those values (normal geometry, concentric hypertrophy, eccentric hypertrophy, concentric remodeling). Transmitral flow parameters for diastolic left ventricular function were also assessed.
Results: There were no signficant differences between groups regarding maternal age (30.47 years vs. 29.53 years, p=0.47), parity (p=0.91) or body mass index (29.82 kg/m2 vs. 28.5 kg/m2, p=0.23). The prevalence of left ventricular hypertrophy, expressed as left ventricu-lar mass (185.75 g vs. 144.85 g, p=0.0023) and relative left ventricular wall thickness (0.49 vs. 0.42, p=0.01), was higher among patients with preeclampsia. The most common remodeling type in females with pre-eclampsia was concentric hypertrophy, while among normal pregnancies, normal geometry and concentric remodeling were most commonly observed. We found no significant differences between transmitral flow pa-rameters for diastolic left ventricular function for the groups, except for E/A ratio (p=0.03).
Conclusions: In our study group, preeclampsia had impact on left ventricular remodelling during preg-nancies. Effects are significant related to left ventricular mass, geometry of ventricular remodeling and diastolic function, assessed through E/A transmitral flow.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)