Maternal myocardial dysfunction after normotensive fetal growth restriction compared with hypertensive pregnancies: a speckle-tracking study

R. Orabona*, Z. Mohseni, E. Sciatti, E.G. Mulder, F. Prefumo, R. Lorusso, T. Frusca, C. Ghossein-Doha, M.E.A. Spaanderman

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

11 Citations (Web of Science)

Abstract

Objective: Pregnancy complicated by preeclampsia and fetal growth restriction (FGR) relates to increased risk of cardiovascular disease later in life, but to different extents. Subclinical cardiac alterations precede eminent cardiovascular disease. Speckle-tracking echocardiography is an elegant method to assess subclinical myocardial dysfunction. We performed a myocardial speckle tracking study to evaluate the prevalence of subclinical myocardial dysfunction in former preeclampsia patients (with and without FGR) compared with normotensive women with FGR. Methods: For this cross-sectional study, we retrospectively selected women with a history of normotensive FGR (n = 17), preeclampsia with FGR (n = 26) and preeclampsia without FGR (n = 134) who underwent conventional echocardiography as part of the clinical cardiovascular work-up after complicated pregnancies between 6 months and 4 years postpartum in Maastricht, The Netherlands. We excluded women with chronic hypertension, hypercholesterolemia and obesity. Results: Women with normotensive FGR showed subclinical left ventricular (LV) impairment in systodiastolic function with concentric remodeling, slight alteration in right ventricular systolic function and left atrial strain, similarly to the preeclampsia group independently from the fetal growth. LV hypertrophy was only present in about 10% of cases who experienced preeclampsia (independently from the fetal growth) but not in those with normotensive FGR. Conclusion: Similar to women with a history preeclampsia, women with a history of normotensive pregnancy but with FGR have abnormal myocardial function, shown with speckle-tracking echocardiography. Therefore, both preeclampsia and normotensive FGR should be viewed upon as risk indicator for subclinical myocardial impairment that may benefit from cardiovascular risk management.
Original languageEnglish
Pages (from-to)1955-1963
Number of pages9
JournalJournal of Hypertension
Volume38
Issue number10
DOIs
Publication statusPublished - 1 Oct 2020

Keywords

  • 2d strain
  • american society
  • disease
  • echocardiography
  • european association
  • fetal growth restriction
  • heart failure
  • heart failure with preserved ejection fraction
  • heart-failure
  • left ventricle
  • longitudinal strain
  • prediction
  • preeclampsia
  • risk
  • speckle-tracking echocardiography
  • ventricular function
  • 2D strain
  • PREECLAMPSIA
  • EUROPEAN ASSOCIATION
  • VENTRICULAR FUNCTION
  • LONGITUDINAL STRAIN
  • ECHOCARDIOGRAPHY
  • HEART-FAILURE
  • RISK
  • PREDICTION
  • DISEASE
  • AMERICAN SOCIETY

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