In:
Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 74, No. Suppl_1 ( 2019-09)
Abstract:
Objectives: Preeclampsia (PE), the leading cause of maternal and neonatal morbidity and mortality, is associated with an increased long-term risk for cardiovascular disease (CVD). We aimed to characterize myocardium and investigate potential functional and structural cardiac alterations in asymptomatic women after PE using cardiovascular magnetic resonance (CMR) imaging. Methods and Results: We performed a post-pregnancy case-control study (clinicaltrials.gov ID: NCT03313063). In total, 22 cases and 23 controls were recruited. Participants were matched by age, BMI and parity. Hemodynamic and morphologic characteristics of the myocardium were assessed using established and innovative CMR technics as parametric mapping, late gadolinium enhancement (LGE) imaging and tissue-tracking. Increased left-atrial end-diastolic volume (LA-EDV normalized to BSA: 37.69±6.83 vs. 32.85±6.28, p=0.02) and stroke volume (LA-SV normalized to BSA: 22.57±5.83 vs 18.96±5.10, p=0.02) with a slight tendency to left-ventricular hypertrophy (LV-SV normalized to BSA: 47.28±7.03 vs. 51.58±6.32, p=0.04, LV remodeling index: 0.59±0.11 vs. 0.53±0.08, p=0.045) were found in the post-PE group. Associations between history of PE and changes in LA dimensions remained even after adjustment for BMI, age, parity, DBP, smoking status and years postpartum (adj. β-coefficient for LA-EDV [95% CI]: 9.14 [1.47; 16.81] , adj. β-coefficient for LA-SV [95% CI]: 6.74 [0.77; 12.70] ). Global circumferential (GCS) and radial (GRS) stains were significantly reduced in post-PE women (-18.28±2.53 vs. -19.82±2.12 and 30.72±6.99 vs. 35.09±6.73, respectively). We could not detect significant differences in T1 or T2 mapping between the groups or fibrosis in LGE imaging. Conclusion: Our findings confirm PE as a risk factor for CVD later in life. Changes in LV and LA dimensions were found as early as 2 years after PE pregnancy. These changes might point toward a manifest end-organ damage following PE in the future. We propose that post-PE women will notably benefit from early cardiovascular screenings.
Type of Medium:
Online Resource
ISSN:
0194-911X
,
1524-4563
DOI:
10.1161/hyp.74.suppl_1.P153
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2019
detail.hit.zdb_id:
2094210-2
