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- Title
Assessment of Left Ventricular Geometry and Function in Preeclamptic and Chronic Arterial Hypertensive Pregnant Women.
- Authors
Elfaramawy, Amr; Baligh, Essam; Adel, Ahmed; Noman, Abdel Hakim; Raouf, Magid Abdel
- Abstract
Background The hemodynamic disorders of preeclampsia (PE); represent a very interesting model in which a pressure overload develops in a few weeks may induces cardiac changes similar to that detected in chronic arterial hypertension (CAH), which is characterized by a long-lasting pressure overload. Our aim is to assess the left ventricular geometry, systolic and diastolic function in PE in comparison to CAH pregnant patients. Methods Twenty five consecutive pregnant women with preeclampsia (PE group) and 25 with chronic arterial hypertension (CAH group) were enrolled in their third trimester of gestation. Conventional M-Mode, 2D and Doppler echocardiography were performed for all patients. Left ventricular mass (LVM), relative left ventricular mass (rLVM), left ventricular mass index (LVMI), as well as relative wall thickness (RWT) were calculated to define the LV geometric pattern. Ejection fraction, fractional shortening, stroke volume and cardiac output were measured to evaluate the LV systolic function. Mitral inflow velocities were used to evaluate the diastolic function. Results Both groups were well matched for their baseline characteristics apart from the age, weight and parity that were higher in (CAH) group (p <0.0001). There were significant increase of LVM; 200.3±72.73vs. 153.6±34.26g, rLVM; 121.4±42.39vs. 95.6±21.84g, LVMI; 108.8±36.49vs. 86±19.19g/m², as well as RWT; 0.46±0.1vs. 0.35±0.1 (P <0.01) in CAH group as compared to PE group. Concentric hypertrophy was the most common geometric abnormality detected in CAH group 44% vs. 12% (p= 0.012) while normal pattern was more evident in PE group 68% vs. 36% (p= 0.024). The concentric remodeling and eccentric hypertrophy pattern were similar in both groups. The ejection fraction, fractional shortening, stroke volume and the cardiac output were high but similar in both groups (p= N.S). The E/A ratio was >1 in both groups but it was statistically lower in CAH group, (p= 0.01). Conclusions Preeclamptic pregnant women have evidence of abnormal left ventricle geometry but less than that detected in CAH with enhanced left ventricular systolic function. These structural and functional cardiac changes justify routine cardiologic assessment, even in the absence of cardiopulmonary symptoms.
- Subjects
HYPERTENSION in pregnancy; BODY mass index; PREGNANCY complications; PREGNANT women; PREECLAMPSIA; BODY weight
- Publication
Heart Mirror Journal, 2013, Vol 7, Issue 2, p101
- ISSN
1687-6652
- Publication type
Article