P-407: Left ventricular structure and function and development of pregnancy-related hypertensive disorders in pregnant women with altered utero-placental flow

• Published in: American journal of hypertension 2005-05, Vol.18 (S4), p.153A-153A
• Main Authors: Esposti, Daniela Degli, Immordino, Vincenzo, Carletti, Angela, Ghi, Tullio, Dormi, Ada, Veronesi, Maddalena, Bacchelli, Stefano, Prandin, Maria Grazia, Borghi, Claudio, Ambrosioni, Ettore
• Format: Article
• Language: English
• Subjects: Echocardiography; Left Ventricular Structure and Function; Pregnancy-Related Hypertension
• ISSN: 0895-7061; 1941-7225; 1879-1905
• DOI: 10.1016/j.amjhyper.2005.03.425

Pregnancy related hypertensive disorders are an important cause of maternal and foetal mortality and morbidity. The real therapeutic option is their precocious identification and optimal delivery timing, this last representing the only efficacious treatment for preeclampsia in particular. Altered utero-placental flow identifies women at higher risk of hypertensive complications. It has been observed that pregnant women who develop hypertensive disorders, and preeclampsia in particular, can present precocious hemodynamic modifications, long before clinical aspects become evident. Aim of the present study was to evaluate if some echocardiographic aspects can precociously identify higher risk pregnant women. Thirty-one consecutive pregnant women with altered utero-placental flow at 21–24th week of gestation underwent complete colour-Doppler-echocardiography, and left ventricular (LV) structure and function were evaluated, with assessment of LV mass, relative wall thickness (RWT) and E/A rate. Clinical follow-up of pregnancy was therefore assessed to distinguish pregnant women in those with and without hypertensive complications. Among hypertensive complications we considered preeclampsia, chronic or gestational hypertension, and intrauterine growth retard. The results are represented in the table: no significant differences between two groups as regard as evaluated parameters were observed. Echocardiographic parameters in not complicated (NC) and complicated (C) pregnant patients LVDD (mm) LVSD (mm) EF (%) CO (l/min) MI (g/m2.7) RWT E/A NC (15 pts, age 31.4 years) 43.6 27.8 70 7.1 39.2 0.39 1.53 C (17 pts, age 32.9 years) 45.9 28 69 6.9 39.5 0.40 1.35 LVDD = LV end diastolic diameter, LVSD = LV end systolic diameter, EF = ejection fraction, CO = cardiac output, MI = LV mass index. In conclusion, none of the examined echocardiographic parameters seems to identify pregnant women at higher risk of developing hypertensive disorders, suggesting that structural and functional LV modifications observed in other clinical settings, for instance, preeclampsia, need hemodynamic overload typical of those conditions to become evident.