Abnormal mid-trimester cardiac strain in women with chronic hypertension predates superimposed preeclampsia

•Retrospective study of patients with chronic hypertension in pregnancy.•Global peak longitudinal strain was measured using automated software from archived images.•Results show that a significant proportion of patients have subclinical abnormal cardiac function in mid trimester.•The presence of abn...

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Bibliographic Details
Published in:Pregnancy hypertension 2017-10, Vol.10, p.251-255
Main Authors: Shahul, Sajid, Ramadan, Hadi, Mueller, Ariel, Nizamuddin, Junaid, Nasim, Rabab, Lopes Perdigao, Joana, Chinthala, Sireesha, Tung, Avery, Rana, Sarosh
Format: Article
Language:English
Subjects:
Adult
Cohort Studies
Female
Humans
Hypertension - physiopathology
Pre-Eclampsia - physiopathology
Pregnancy
Pregnancy Complications, Cardiovascular - physiopathology
Pregnancy Outcome
Pregnancy Trimester, Second
Retrospective Studies
Ultrasonography, Prenatal
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Summary:•Retrospective study of patients with chronic hypertension in pregnancy.•Global peak longitudinal strain was measured using automated software from archived images.•Results show that a significant proportion of patients have subclinical abnormal cardiac function in mid trimester.•The presence of abnormal cardiac strain was associated with superimposed preeclampsia and preterm delivery.•Further studies are needed to confirm these findings. Chronic hypertension (cHTN) affects 7% of all pregnancies. We hypothesized that cHTN during pregnancy would be associated with abnormal myocardial strain patterns and adverse perinatal outcomes. This was a retrospective cohort study of patients seen in a high-risk obstetrics clinic with cHTN. Parturients with a singleton pregnancy who had undergone an echocardiogram as part of routine clinical care were eligible. Clinical and demographic information was collected from medical records. Global peak longitudinal strain (GLS) was measured using automated software from stored echocardiographic images. 60 patients were included in this analysis, of which 48 (80.0%) were African American. The median BMI was 40.6, age was 34 years, and the gestational age was 20.4 weeks at the time of the echo and 37.9 weeks at delivery. Thirty-four patients (56.7%) demonstrated abnormal strain, defined as a GLS 
ISSN:2210-7789
2210-7797
DOI:10.1016/j.preghy.2017.10.009