We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Pre-eclampsia: an important risk factor for asymptomatic heart failure.
- Authors
Ghossein-Doha, Chahinda; van Neer, Jolijn; Wissink, Brechtje; Breetveld, Nicolette; de Windt, Leon J; van Dijk, Arie Pj; van der Vlugt, Maureen J; Janssen, Mirian Ch; Heidema, Wieteke M; Scholten, Ralph R; Spaanderman, Marc Ea; Ghossein-Doha, C; van Neer, J; Wissink, B; Breetveld, N M; de Windt, L J; van Dijk, A P J; van der Vlugt, M J; Janssen, M C H; Heidema, W M
- Abstract
<bold>Objectives: </bold>Pre-eclampsia (PE) is associated with both postpartum structural asymptomatic heart disease (i.e. heart failure Stage B (HF-B)) and conventional cardiovascular (CV) risk factors. We aimed to evaluate the extent to which PE, adjusted for conventional CV risk factors, is associated independently with asymptomatic cardiac abnormalities postpartum.<bold>Methods: </bold>In this cross-sectional cohort study, 107 formerly pre-eclamptic women and 41 women with uneventful previous pregnancy (controls) were invited for CV risk assessment 4-10 years postpartum. This included cardiac ultrasound, blood pressure (BP) measurement and evaluation of metabolic syndrome determinants. Asymptomatic structural and functional cardiac abnormalities were classified as HF-B, according to the American Heart Association guidelines. Prehypertension was defined as systolic BP of 120-139 mmHg and/or diastolic BP of 80-89 mmHg. Univariate and multivariate regression analyses were performed to calculate associations of PE and conventional risk factors with HF-B.<bold>Results: </bold>The prevalence of asymptomatic HF-B was approximately 3.5-fold higher in the PE group compared with controls (25% vs 7%, P < 0.01); 67% of this group had concentric remodeling and 22% had mildly impaired ejection fraction. After adjustment for postpartum interval, hypertension and high-density lipoprotein, PE was significantly associated with HF-B (adjusted odds ratio, 4.4 (95% CI, 1.0-19.1)). Moreover, in the formerly pre-eclamptic group, prehypertension was associated significantly with HF-B (odds ratio, 4.3 (95% CI, 1.4-12.7)), while metabolic syndrome determinants were not.<bold>Conclusion: </bold>PE is associated with a four-fold increased female-specific risk of asymptomatic cardiac abnormalities. Prehypertension apparently increases this risk significantly, while metabolic syndrome determinants do not. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
- Subjects
HEART; HEART failure; LONGITUDINAL method; PREECLAMPSIA; ULTRASONIC imaging; CROSS-sectional method
- Publication
Ultrasound in Obstetrics & Gynecology, 2016, Vol 48, Issue 5, pN.PAG
- ISSN
0960-7692
- Publication type
journal article
- DOI
10.1002/uog.17343