Fetal and Neonatal Modified Myocardial Performance Indices in Preeclamptic versus Normotensive Pregnancies: A Prospective Cohort Study

Figures & data

Figure 1 (A) Measurement of ICT, IRT, and ET. (B) Measurement of MV-E PV and MV-A PV.

Table 1 Data Characteristics

Characteristic	Normal Blood Pressure (n=29)	Preeclampsia (n=29)	P-value
Maternal age (years)	30.83±6.06	30.55±6.10	0.86
Primigravida (%)	13 (43.3)	15 (51.7)	0.52
Gestational age (weeks)	35.10±4.00	36.21±2.92	0.23
Mean arterial pressure (mmHg)	88.43±7.08	115.24±11.25	<0.001
Pre-pregnancy BMI (kg/m^2)	27.99±5.17	30.17±4.75	0.10
Fetal heart rate (bpm)	141.47±9.26	143.07±8.73	0.50
Neonatal birth weight (grams)	2,919.96±504.20	2,735.36±826.47	0.32
Apgar score at 1st minute <7 (%)	1 (3.57)	6 (21.4)	0.04
Neonatal heart rate (bpm)	138.93±10.24	142.11±10.23	0.25
Neonatal oxygen saturation (%)	98.08±2.31	97.38±2.30	0.29

Notes: Data are represented as mean SD and frequency (percentage).

Figure 2 Flow chart for the enrollment of study participants.

Table 2 Comparison of Fetal Cardiac Function between Preeclampsia and Normotensive Blood Pressure Groups

Cardiac Function	Normal Blood Pressure (n=29)	Preeclampsia (n=29)	Mean Difference (95% CI)	P-value
Left side heart
ICT (ms)	45.72±7.28	42.88±11.27	2.36 (−2.78–7.50)	0.361
IRT (ms)	47.85±7.27	49.16±12.57	1.90 (−3.70–7.50)	0.500
ET (ms)	158.16±13.45	154.39±33.50	4.61 (−9.15–18.38)	0.505
Mod-MPI	0.59±0.08	0.60±0.08	0.02 (−0.02–0.06)	0.341
MV-E PV (cm/s)	30.67±6.64	29.89±6.89	0.40 (−3.34–4.14)	0.833
MV-A PV (cm/s)	42.16±7.75	40.27±8.49	0.92 (−3.44–5.28)	0.674
MV E:A	0.73±0.09	0.74±0.06	0.01 (−0.03–0.05)	0.673
Ao PSV (cm/s)	66.02±12.05	71.01±22.21	6.53 (−3.03–16.09)	0.176
Right side heart
ICT (ms)	42.98±14.69	44.89±11.92	0.27 (−6.91–7.45)	0.940
IRT (ms)	45.34±17.88	48.59±11.80	2.37 (−5.93–10.66)	0.569
ET (ms)	147.15±53.56	161.60±36.97	11.73 (−13.46–34.92)	0.378
Mod-MPI	0.54±0.21	0.57±0.16	0.01 (−0.09–0.11)	0.861
TV-E PV (cm/s)	32.22±10.15	30.05±13.25	1.55 (−4.75–7.85)	0.624
TV-A PV (cm/s)	44.81±12.99	40.12±15.49	3.71 (−3.93–11.35)	0.334
TV E:A	0.691±0.15	0.68±0.21	0.01 (−0.09–0.11)	0.846
PA PSV (cm/s)	60.99±11.52	62.64±18.79	3.06 (−5.30–11.41)	0.467

Notes: Data are represented in mean±SD and frequency with percentage. Mean difference adjusted by gestational age, fetal heart rate, and estimated fetal weight.

Abbreviations: ICT, isovolumetric contraction time; IRT, isovolumetric relaxation time; ET, ejection time; Mod-MPI, modified myocardial performance index; Ao PSV, aortic peak systolic velocity; MV-E PV, mitral valve E-wave peak velocity; MV-A PV, mitral valve A-wave peak velocity; MV E:A, mitral valve E:A wave ratio; TV-E PV, tricuspid valve E-wave peak velocity; TV-A PV, tricuspid valve A-wave peak velocity; TV E:A, tricuspid valve E:A wave ratio; PA PSV, pulmonary artery peak systolic velocity.

Figure 3 Box-plot of (A) fetal left Mod-MPI and (B) fetal right Mod-MPI in preeclampsia with or without severe features and the control groups.

Table 3 Comparison of Neonatal Left Side Cardiac Functions between Preeclampsia and Normotensive Blood Pressure Groups

Left Side Cardiac Function	Normal Blood Pressure (n=25)	Preeclampsia (n=23)	Mean Difference (95% CI)	P-value
Mod-MPI	0.50±0.25	0.44±0.11	0.05 (−0.09–0.21)	0.436
MV-E PV (cm/s	43.56±5.21	51.10±8.02	7.46 (0.54–14.37)	0.036
MV-A PV (cm/sec)	55.88±8.43	65.80±12.66	7.89 (−2.21–18.00)	0.119
MV E:A ratio	0.78±0.08	0.80±0.08	0.03 (−0.04–0.10)	0.379
Ao PSV (cm/s)	86.89±12.58	83.19±18.29	2.64 (−11.82–17.09)	0.709

Notes: Data are represented as mean±SD and frequency percentage. Mean differences are adjusted by neonatal heart rate.