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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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| Published in: | Pregnancy hypertension 2017-10, Vol.10, p.251-255 |
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| container_title | Pregnancy hypertension |
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| creator | Shahul, Sajid Ramadan, Hadi Mueller, Ariel Nizamuddin, Junaid Nasim, Rabab Lopes Perdigao, Joana Chinthala, Sireesha Tung, Avery Rana, Sarosh |
| description | •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 |
| doi_str_mv | 10.1016/j.preghy.2017.10.009 |
| format | article |
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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 <= −19%. Patients with abnormal strain were similar in age and BMI to patients with normal cardiac function. When compared to women with normal strain, those with abnormal strain had lower stroke volume (69.0 ml vs 81.5 ml; p = .001) and ejection fraction (49.6% vs 57.5%; p < .0001). Rates of superimposed preeclampsia were higher (38.2% vs 11.5%, p-value = .02) and a higher proportion of patients in the abnormal strain group delivered before 37 weeks (44.1% vs 19.2%; p = .04).
In a population of parturients with cHTN, we found that more than one-half demonstrated subclinical abnormal cardiac function. The presence of abnormal cardiac strain predates superimposed preeclampsia and preterm delivery. Further studies are needed to validate these findings.</description><identifier>ISSN: 2210-7789</identifier><identifier>EISSN: 2210-7797</identifier><identifier>DOI: 10.1016/j.preghy.2017.10.009</identifier><identifier>PMID: 29111424</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Adult ; Cohort Studies ; Female ; Humans ; Hypertension - physiopathology ; Pre-Eclampsia - physiopathology ; Pregnancy ; Pregnancy Complications, Cardiovascular - physiopathology ; Pregnancy Outcome ; Pregnancy Trimester, Second ; Retrospective Studies ; Ultrasonography, Prenatal</subject><ispartof>Pregnancy hypertension, 2017-10, Vol.10, p.251-255</ispartof><rights>2017 International Society for the Study of Hypertension in Pregnancy</rights><rights>Copyright © 2017 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c362t-52e10e2c178196cdcaf290b22669ed9975575157fc6e9d97777f444078544bc63</citedby><cites>FETCH-LOGICAL-c362t-52e10e2c178196cdcaf290b22669ed9975575157fc6e9d97777f444078544bc63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29111424$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shahul, Sajid</creatorcontrib><creatorcontrib>Ramadan, Hadi</creatorcontrib><creatorcontrib>Mueller, Ariel</creatorcontrib><creatorcontrib>Nizamuddin, Junaid</creatorcontrib><creatorcontrib>Nasim, Rabab</creatorcontrib><creatorcontrib>Lopes Perdigao, Joana</creatorcontrib><creatorcontrib>Chinthala, Sireesha</creatorcontrib><creatorcontrib>Tung, Avery</creatorcontrib><creatorcontrib>Rana, Sarosh</creatorcontrib><title>Abnormal mid-trimester cardiac strain in women with chronic hypertension predates superimposed preeclampsia</title><title>Pregnancy hypertension</title><addtitle>Pregnancy Hypertens</addtitle><description>•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 <= −19%. Patients with abnormal strain were similar in age and BMI to patients with normal cardiac function. When compared to women with normal strain, those with abnormal strain had lower stroke volume (69.0 ml vs 81.5 ml; p = .001) and ejection fraction (49.6% vs 57.5%; p < .0001). Rates of superimposed preeclampsia were higher (38.2% vs 11.5%, p-value = .02) and a higher proportion of patients in the abnormal strain group delivered before 37 weeks (44.1% vs 19.2%; p = .04).
In a population of parturients with cHTN, we found that more than one-half demonstrated subclinical abnormal cardiac function. The presence of abnormal cardiac strain predates superimposed preeclampsia and preterm delivery. Further studies are needed to validate these findings.</description><subject>Adult</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Humans</subject><subject>Hypertension - physiopathology</subject><subject>Pre-Eclampsia - physiopathology</subject><subject>Pregnancy</subject><subject>Pregnancy Complications, Cardiovascular - physiopathology</subject><subject>Pregnancy Outcome</subject><subject>Pregnancy Trimester, Second</subject><subject>Retrospective Studies</subject><subject>Ultrasonography, Prenatal</subject><issn>2210-7789</issn><issn>2210-7797</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNp9kF1LwzAUhoMobsz9A5FeetOaZGnS3Ahj-AUDb_Q6ZMmpy2ybmnTK_r0Zm7v0EJLw8p6vB6FrgguCCb_bFH2Aj_WuoJiIJBUYyzM0ppTgXAgpzk__So7QNMYNTsFKXAl-iUZUEkIYZWP0OV91PrS6yVpn8yG4FuIAITM6WKdNFoegXZel8-NbSLcb1plZB985k613PYQBuuh8l6WBrB4gZnGbVNf2PoLdq2Aa3fbR6St0UesmwvT4TtD748Pb4jlfvj69LObL3Mw4HfKSAsFADREVkdxYo2sq8YpSziVYKUVZipKUojYcpJUiRc0Yw6IqGVsZPpug20PdPvivbdpHtS4aaBrdgd9GlaoSPqtkJZOVHawm-BgD1KpPo-uwUwSrPWm1UQfSak96rybSKe3m2GG7asGekv64JsP9wQBpz28HQUXjoDNgXQAzKOvd_x1-Aca5kpQ</recordid><startdate>201710</startdate><enddate>201710</enddate><creator>Shahul, Sajid</creator><creator>Ramadan, Hadi</creator><creator>Mueller, Ariel</creator><creator>Nizamuddin, Junaid</creator><creator>Nasim, Rabab</creator><creator>Lopes Perdigao, Joana</creator><creator>Chinthala, Sireesha</creator><creator>Tung, Avery</creator><creator>Rana, Sarosh</creator><general>Elsevier B.V</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>7X8</scope></search><sort><creationdate>201710</creationdate><title>Abnormal mid-trimester cardiac strain in women with chronic hypertension predates superimposed preeclampsia</title><author>Shahul, Sajid ; Ramadan, Hadi ; Mueller, Ariel ; Nizamuddin, Junaid ; Nasim, Rabab ; Lopes Perdigao, Joana ; Chinthala, Sireesha ; Tung, Avery ; Rana, Sarosh</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c362t-52e10e2c178196cdcaf290b22669ed9975575157fc6e9d97777f444078544bc63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Humans</topic><topic>Hypertension - physiopathology</topic><topic>Pre-Eclampsia - physiopathology</topic><topic>Pregnancy</topic><topic>Pregnancy Complications, Cardiovascular - physiopathology</topic><topic>Pregnancy Outcome</topic><topic>Pregnancy Trimester, Second</topic><topic>Retrospective Studies</topic><topic>Ultrasonography, Prenatal</topic><toplevel>online_resources</toplevel><creatorcontrib>Shahul, Sajid</creatorcontrib><creatorcontrib>Ramadan, Hadi</creatorcontrib><creatorcontrib>Mueller, Ariel</creatorcontrib><creatorcontrib>Nizamuddin, Junaid</creatorcontrib><creatorcontrib>Nasim, Rabab</creatorcontrib><creatorcontrib>Lopes Perdigao, Joana</creatorcontrib><creatorcontrib>Chinthala, Sireesha</creatorcontrib><creatorcontrib>Tung, Avery</creatorcontrib><creatorcontrib>Rana, Sarosh</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Pregnancy hypertension</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shahul, Sajid</au><au>Ramadan, Hadi</au><au>Mueller, Ariel</au><au>Nizamuddin, Junaid</au><au>Nasim, Rabab</au><au>Lopes Perdigao, Joana</au><au>Chinthala, Sireesha</au><au>Tung, Avery</au><au>Rana, Sarosh</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Abnormal mid-trimester cardiac strain in women with chronic hypertension predates superimposed preeclampsia</atitle><jtitle>Pregnancy hypertension</jtitle><addtitle>Pregnancy Hypertens</addtitle><date>2017-10</date><risdate>2017</risdate><volume>10</volume><spage>251</spage><epage>255</epage><pages>251-255</pages><issn>2210-7789</issn><eissn>2210-7797</eissn><abstract>•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 <= −19%. Patients with abnormal strain were similar in age and BMI to patients with normal cardiac function. When compared to women with normal strain, those with abnormal strain had lower stroke volume (69.0 ml vs 81.5 ml; p = .001) and ejection fraction (49.6% vs 57.5%; p < .0001). Rates of superimposed preeclampsia were higher (38.2% vs 11.5%, p-value = .02) and a higher proportion of patients in the abnormal strain group delivered before 37 weeks (44.1% vs 19.2%; p = .04).
In a population of parturients with cHTN, we found that more than one-half demonstrated subclinical abnormal cardiac function. The presence of abnormal cardiac strain predates superimposed preeclampsia and preterm delivery. Further studies are needed to validate these findings.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>29111424</pmid><doi>10.1016/j.preghy.2017.10.009</doi><tpages>5</tpages></addata></record> |
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| 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 |
| title | Abnormal mid-trimester cardiac strain in women with chronic hypertension predates superimposed preeclampsia |
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