Post-partum evaluation of maternal cardiac function after severe preeclampsia

作者：Ghi Tullio^*; Degli Esposti Daniela; Montaguti Elisa; Rosticci Martina; De Musso Francesca; Youssef Aly; Salsi Ginevra; Pilu Gianluigi; Borghi Claudio; Rizzo Nicola

来源：Journal of Maternal-Fetal and Neonatal Medicine, 2014, 27(7): 696-701.

DOI：10.3109/14767058.2013.834325

• Echocardiography
• hypertension
• myocardial dysfunction
• preeclampsia
• tissue Doppler

Objective: To evaluate the post-partum maternal cardiac function in patients with history of severe preeclampsia.
Methods: A series of women with previous singleton pregnancy complicated by severe preeclampsia underwent transthoracic echocardiography at 6-12 months from delivery. A group of women with previous uncomplicated pregnancy was selected as controls.
Results: Sixteen women with history of severe preeclampsia were enrolled in the study group whereas 18 patients were selected as controls. In the study group systolic (p = 0.002) and diastolic blood pressure (p = 0.044) were significantly higher. Significant differences were observed in systolic left ventricular (LV) parameters, such as cardiac output (p = 0.034), LV mass indexed to BSA (p = 0.024) and longitudinal contraction, expressed by tissue Doppler (TD) S-1 wave, which resulted relatively impaired in former preeclamptic women (p = 0.049). As regards as diastolic parameters, pulsed Doppler A-wave velocity was increased (p = 0.036). TD E-wave velocity was significantly lower in study group (p<0.001) and E/E-1 ratio (E peak early diastole transmitral wave velocity/E-1 peak early diastolic velocity at mitral valve annulus at TD) was higher respect to controls (p<0.001).
Conclusions: LV contractility and diastolic function, although within normal reference ranges, show slight but significant impairment among women who experienced a severe preeclampsia. TD seems to be a sensible tool to identify these precocious signs of potential LV dysfunction.

• 出版日期2014-4