Post-partum evaluation of maternal cardiac function after severe preeclampsia

Abstract

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) S₁ 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/E₁ ratio (E = peak early diastole transmitral wave velocity/E₁ = 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.

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