Abstract
Objectives After pre-eclampsia (PE), the prevalence of structural heart disease without symptoms, i.e. heart failure Stage B (HF-B), may be as high as one in four women in the first year postpartum. We hypothesize that a significant number of formerly pre-eclamptic women with HF-B postpartum are still in their resolving period and will not have HF-B during follow-up.
Methods In this prospective longitudinal cohort study, we included 69 formerly pre-eclamptic women who underwent serial echocardiographic measurements at 1 and 4 years postpartum. HF-B was diagnosed as left ventricular hypertrophy (left ventricular mass index (LVMi) > 95 g/m(2)), concentric remodeling (relative wall thickness > 0.42 and LVMi 40% and
Results The prevalence of HF-B in formerly pre-eclamptic women was 23% in the first year postpartum and 23% after 4 years. At the second visit, HF-B had resolved in 62.5% of affected women but was newly developed in 19% of initially unaffected women. At the first visit, 56% of women diagnosed with HF-B had reduced systolic function whereas at the second visit 69% of women with HF-B had concentric remodeling with mostly normal ejection fraction, consistent with diastolic dysfunction.
Conclusions The prevalence of HF-B can be considered consistently high (1 in 4) amongst formerly pre-eclamptic women at follow-up. Nonetheless, at an individual level, more than 60% of women found initially to be affected by HF-B will recover, whilst about 20% of formerly pre-eclamptic women with normal echocardiography in the first year postpartum will develop HF-B over the following years. Copyright (C) 2016 ISUOG. Published by John Wiley & Sons Ltd.
Original language | English |
---|---|
Pages (from-to) | 134-142 |
Number of pages | 9 |
Journal | Ultrasound in Obstetrics & Gynecology |
Volume | 49 |
Issue number | 1 |
DOIs | |
Publication status | Published - Jan 2017 |
Keywords
- cardiovascular disease
- echocardiography
- heart failure
- HFpEF
- pre-eclampsia
- PRESERVED EJECTION FRACTION
- CARDIOVASCULAR-DISEASE
- HYPERTENSION
- ECHOCARDIOGRAPHY
- ASSOCIATION
- PREGNANCY
- RISK
- RECOMMENDATIONS
- DYSFUNCTION
- GUIDELINES