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Maternal cardiac adaptation to subsequent pregnancy in formerly pre‐eclamptic women according to recurrence of pre‐eclampsia
ABSTRACT Objectives Left‐ventricular remodeling in women with pre‐eclampsia (PE) is concentric rather than eccentric, and tends to persist postpartum, particularly after early‐onset PE. This study was designed to determine whether prepregnancy cardiac geometry and function along with cardiac adaptat...
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| Published in: | Ultrasound in obstetrics & gynecology 2016-01, Vol.47 (1), p.96-103 |
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| container_title | Ultrasound in obstetrics & gynecology |
| container_volume | 47 |
| creator | Ghossein‐Doha, C. Spaanderman, M. E. A. Al Doulah, R. Van Kuijk, S. M. Peeters, L. L. H. |
| description | ABSTRACT
Objectives
Left‐ventricular remodeling in women with pre‐eclampsia (PE) is concentric rather than eccentric, and tends to persist postpartum, particularly after early‐onset PE. This study was designed to determine whether prepregnancy cardiac geometry and function along with cardiac adaptation to the subsequent pregnancy in former early‐onset PE patients differs between those who do and those who do not develop recurrent PE later on in their second pregnancy.
Methods
In 51 women with a history of early‐onset PE, we performed serial cardiac ultrasound examinations and recorded automated measurements of blood pressure/heart rate before pregnancy and again at three consecutive times in the first half of their subsequent pregnancy. From the hospital records, we retrieved information on pregnancy outcome. We compared intergroup differences in cardiac indices using independent samples t‐test, and intergroup differences in prepregnant cardiac ultrasound indices and subsequent pregnancy‐induced cardiac adaptive response using repeated‐measures ANOVA.
Results
PE recurred in 14/51 (27%) women. Preconception, the recurrent‐PE group differed from the non‐recurrent‐PE group by having a lower left‐ventricular mass (LVM) index (28 vs 32 g/m2.7, P |
| doi_str_mv | 10.1002/uog.15752 |
| format | article |
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Objectives
Left‐ventricular remodeling in women with pre‐eclampsia (PE) is concentric rather than eccentric, and tends to persist postpartum, particularly after early‐onset PE. This study was designed to determine whether prepregnancy cardiac geometry and function along with cardiac adaptation to the subsequent pregnancy in former early‐onset PE patients differs between those who do and those who do not develop recurrent PE later on in their second pregnancy.
Methods
In 51 women with a history of early‐onset PE, we performed serial cardiac ultrasound examinations and recorded automated measurements of blood pressure/heart rate before pregnancy and again at three consecutive times in the first half of their subsequent pregnancy. From the hospital records, we retrieved information on pregnancy outcome. We compared intergroup differences in cardiac indices using independent samples t‐test, and intergroup differences in prepregnant cardiac ultrasound indices and subsequent pregnancy‐induced cardiac adaptive response using repeated‐measures ANOVA.
Results
PE recurred in 14/51 (27%) women. Preconception, the recurrent‐PE group differed from the non‐recurrent‐PE group by having a lower left‐ventricular mass (LVM) index (28 vs 32 g/m2.7, P < 0.05) and stroke volume (68 vs 77 mL, P < 0.05), and a higher resting heart rate (71 vs 64 bpm, P < 0.05). Despite these prepregnancy differences, the pregnancy‐induced pattern of cardiac adaptive response was comparable in the two subgroups. After excluding hypertensive women, prepregnancy values for the LVM index remained significantly lower in the recurrent‐PE group.
Conclusions
Women with recurrent PE differed from the non‐recurrent‐PE group by having a lower LVM index and stroke volume, and a higher heart rate, but they responded to their subsequent pregnancy with a similar pattern of cardiac adaptation. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.</description><identifier>ISSN: 0960-7692</identifier><identifier>EISSN: 1469-0705</identifier><identifier>DOI: 10.1002/uog.15752</identifier><identifier>PMID: 26395883</identifier><identifier>CODEN: UOGYFJ</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Adaptation, Physiological ; Adult ; cardiac adaptation ; Case-Control Studies ; Echocardiography ; Echocardiography, Doppler ; Female ; Heart Rate ; Heart Ventricles - diagnostic imaging ; Humans ; left ventricular geometry ; left ventricular mass ; Odds Ratio ; Pre-Eclampsia - diagnostic imaging ; Pre-Eclampsia - epidemiology ; Pregnancy ; pre‐eclampsia ; Recurrence ; recurrent pre‐eclampsia ; Stroke Volume ; Vascular Resistance ; Ventricular Remodeling ; Young Adult</subject><ispartof>Ultrasound in obstetrics & gynecology, 2016-01, Vol.47 (1), p.96-103</ispartof><rights>Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.</rights><rights>Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4872-ac55202899a075646388cf9c041c9a7fea09242ece87dcb94bac526d8491b5163</citedby><cites>FETCH-LOGICAL-c4872-ac55202899a075646388cf9c041c9a7fea09242ece87dcb94bac526d8491b5163</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26395883$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ghossein‐Doha, C.</creatorcontrib><creatorcontrib>Spaanderman, M. E. A.</creatorcontrib><creatorcontrib>Al Doulah, R.</creatorcontrib><creatorcontrib>Van Kuijk, S. M.</creatorcontrib><creatorcontrib>Peeters, L. L. H.</creatorcontrib><title>Maternal cardiac adaptation to subsequent pregnancy in formerly pre‐eclamptic women according to recurrence of pre‐eclampsia</title><title>Ultrasound in obstetrics & gynecology</title><addtitle>Ultrasound Obstet Gynecol</addtitle><description>ABSTRACT
Objectives
Left‐ventricular remodeling in women with pre‐eclampsia (PE) is concentric rather than eccentric, and tends to persist postpartum, particularly after early‐onset PE. This study was designed to determine whether prepregnancy cardiac geometry and function along with cardiac adaptation to the subsequent pregnancy in former early‐onset PE patients differs between those who do and those who do not develop recurrent PE later on in their second pregnancy.
Methods
In 51 women with a history of early‐onset PE, we performed serial cardiac ultrasound examinations and recorded automated measurements of blood pressure/heart rate before pregnancy and again at three consecutive times in the first half of their subsequent pregnancy. From the hospital records, we retrieved information on pregnancy outcome. We compared intergroup differences in cardiac indices using independent samples t‐test, and intergroup differences in prepregnant cardiac ultrasound indices and subsequent pregnancy‐induced cardiac adaptive response using repeated‐measures ANOVA.
Results
PE recurred in 14/51 (27%) women. Preconception, the recurrent‐PE group differed from the non‐recurrent‐PE group by having a lower left‐ventricular mass (LVM) index (28 vs 32 g/m2.7, P < 0.05) and stroke volume (68 vs 77 mL, P < 0.05), and a higher resting heart rate (71 vs 64 bpm, P < 0.05). Despite these prepregnancy differences, the pregnancy‐induced pattern of cardiac adaptive response was comparable in the two subgroups. After excluding hypertensive women, prepregnancy values for the LVM index remained significantly lower in the recurrent‐PE group.
Conclusions
Women with recurrent PE differed from the non‐recurrent‐PE group by having a lower LVM index and stroke volume, and a higher heart rate, but they responded to their subsequent pregnancy with a similar pattern of cardiac adaptation. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.</description><subject>Adaptation, Physiological</subject><subject>Adult</subject><subject>cardiac adaptation</subject><subject>Case-Control Studies</subject><subject>Echocardiography</subject><subject>Echocardiography, Doppler</subject><subject>Female</subject><subject>Heart Rate</subject><subject>Heart Ventricles - diagnostic imaging</subject><subject>Humans</subject><subject>left ventricular geometry</subject><subject>left ventricular mass</subject><subject>Odds Ratio</subject><subject>Pre-Eclampsia - diagnostic imaging</subject><subject>Pre-Eclampsia - epidemiology</subject><subject>Pregnancy</subject><subject>pre‐eclampsia</subject><subject>Recurrence</subject><subject>recurrent pre‐eclampsia</subject><subject>Stroke Volume</subject><subject>Vascular Resistance</subject><subject>Ventricular Remodeling</subject><subject>Young Adult</subject><issn>0960-7692</issn><issn>1469-0705</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNqFkc1q3TAQRkVpaW7TLvoCRdBNsnAiyfpdltCkgZRsmrUZy-OLgy25kk24uzxCnrFPEjs3DbRQuhoYzndg5iPkI2cnnDFxOsftCVdGiVdkw6V2BTNMvSYb5jQrjHbigLzL-ZYxpmWp35IDoUunrC035P47TJgC9NRDajrwFBoYJ5i6GOgUaZ7rjD9nDBMdE24DBL-jXaBtTAOmfrduf90_oO9hGKfO07s4YKDgfVx0Ybs6Evo5JQweaWz_COQO3pM3LfQZPzzPQ3Jz_vXH2bfi6vri8uzLVeGlNaIAr5RgwjoHzCgtdWmtb51nknsHpkVgTkiBHq1pfO1kvSSEbqx0vFZcl4fkaO8dU1zuyVM1dNlj30PAOOeKW8WMKUtt_48aJZVY_r2in_9Cb-O8vvOJKh1TTJuFOt5TPsWcE7bVmLoB0q7irFobrJYGq6cGF_bTs3GuB2xeyN-VLcDpHrjretz921TdXF_slY-90Kg5</recordid><startdate>201601</startdate><enddate>201601</enddate><creator>Ghossein‐Doha, C.</creator><creator>Spaanderman, M. E. A.</creator><creator>Al Doulah, R.</creator><creator>Van Kuijk, S. M.</creator><creator>Peeters, L. L. H.</creator><general>John Wiley & Sons, Ltd</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>201601</creationdate><title>Maternal cardiac adaptation to subsequent pregnancy in formerly pre‐eclamptic women according to recurrence of pre‐eclampsia</title><author>Ghossein‐Doha, C. ; Spaanderman, M. E. A. ; Al Doulah, R. ; Van Kuijk, S. M. ; Peeters, L. L. H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4872-ac55202899a075646388cf9c041c9a7fea09242ece87dcb94bac526d8491b5163</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adaptation, Physiological</topic><topic>Adult</topic><topic>cardiac adaptation</topic><topic>Case-Control Studies</topic><topic>Echocardiography</topic><topic>Echocardiography, Doppler</topic><topic>Female</topic><topic>Heart Rate</topic><topic>Heart Ventricles - diagnostic imaging</topic><topic>Humans</topic><topic>left ventricular geometry</topic><topic>left ventricular mass</topic><topic>Odds Ratio</topic><topic>Pre-Eclampsia - diagnostic imaging</topic><topic>Pre-Eclampsia - epidemiology</topic><topic>Pregnancy</topic><topic>pre‐eclampsia</topic><topic>Recurrence</topic><topic>recurrent pre‐eclampsia</topic><topic>Stroke Volume</topic><topic>Vascular Resistance</topic><topic>Ventricular Remodeling</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ghossein‐Doha, C.</creatorcontrib><creatorcontrib>Spaanderman, M. E. A.</creatorcontrib><creatorcontrib>Al Doulah, R.</creatorcontrib><creatorcontrib>Van Kuijk, S. M.</creatorcontrib><creatorcontrib>Peeters, L. L. H.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Ultrasound in obstetrics & gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ghossein‐Doha, C.</au><au>Spaanderman, M. E. A.</au><au>Al Doulah, R.</au><au>Van Kuijk, S. M.</au><au>Peeters, L. L. H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Maternal cardiac adaptation to subsequent pregnancy in formerly pre‐eclamptic women according to recurrence of pre‐eclampsia</atitle><jtitle>Ultrasound in obstetrics & gynecology</jtitle><addtitle>Ultrasound Obstet Gynecol</addtitle><date>2016-01</date><risdate>2016</risdate><volume>47</volume><issue>1</issue><spage>96</spage><epage>103</epage><pages>96-103</pages><issn>0960-7692</issn><eissn>1469-0705</eissn><coden>UOGYFJ</coden><abstract>ABSTRACT
Objectives
Left‐ventricular remodeling in women with pre‐eclampsia (PE) is concentric rather than eccentric, and tends to persist postpartum, particularly after early‐onset PE. This study was designed to determine whether prepregnancy cardiac geometry and function along with cardiac adaptation to the subsequent pregnancy in former early‐onset PE patients differs between those who do and those who do not develop recurrent PE later on in their second pregnancy.
Methods
In 51 women with a history of early‐onset PE, we performed serial cardiac ultrasound examinations and recorded automated measurements of blood pressure/heart rate before pregnancy and again at three consecutive times in the first half of their subsequent pregnancy. From the hospital records, we retrieved information on pregnancy outcome. We compared intergroup differences in cardiac indices using independent samples t‐test, and intergroup differences in prepregnant cardiac ultrasound indices and subsequent pregnancy‐induced cardiac adaptive response using repeated‐measures ANOVA.
Results
PE recurred in 14/51 (27%) women. Preconception, the recurrent‐PE group differed from the non‐recurrent‐PE group by having a lower left‐ventricular mass (LVM) index (28 vs 32 g/m2.7, P < 0.05) and stroke volume (68 vs 77 mL, P < 0.05), and a higher resting heart rate (71 vs 64 bpm, P < 0.05). Despite these prepregnancy differences, the pregnancy‐induced pattern of cardiac adaptive response was comparable in the two subgroups. After excluding hypertensive women, prepregnancy values for the LVM index remained significantly lower in the recurrent‐PE group.
Conclusions
Women with recurrent PE differed from the non‐recurrent‐PE group by having a lower LVM index and stroke volume, and a higher heart rate, but they responded to their subsequent pregnancy with a similar pattern of cardiac adaptation. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>26395883</pmid><doi>10.1002/uog.15752</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Ultrasound in obstetrics & gynecology, 2016-01, Vol.47 (1), p.96-103 |
| issn | 0960-7692 1469-0705 |
| language | eng |
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| source | Wiley-Blackwell Read & Publish Collection |
| subjects | Adaptation, Physiological Adult cardiac adaptation Case-Control Studies Echocardiography Echocardiography, Doppler Female Heart Rate Heart Ventricles - diagnostic imaging Humans left ventricular geometry left ventricular mass Odds Ratio Pre-Eclampsia - diagnostic imaging Pre-Eclampsia - epidemiology Pregnancy pre‐eclampsia Recurrence recurrent pre‐eclampsia Stroke Volume Vascular Resistance Ventricular Remodeling Young Adult |
| title | Maternal cardiac adaptation to subsequent pregnancy in formerly pre‐eclamptic women according to recurrence of pre‐eclampsia |
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