Left ventricular function many years after recovery from pre‐eclampsia

• Published in: BJOG : an international journal of obstetrics and gynaecology 2011-01, Vol.118 (1), p.76-83
• Main Authors: Strobl, I, Windbichler, G, Strasak, A, Weiskopf‐Schwendinger, V, Schweigmann, U, Ramoni, A, Scheier, M
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Cardiac function; Cardiovascular disease; Case-Control Studies; Diseases of mother, fetus and pregnancy; Echocardiography; Epidemiology; Female; Gynecology. Andrology. Obstetrics; HELLP Syndrome - physiopathology; Hemodynamics - physiology; Humans; maternal haemodynamics; Medical sciences; Myocardial Contraction - physiology; Observer Variation; Pre-Eclampsia - physiopathology; Preeclampsia; Pregnancy; Pregnancy. Fetus. Placenta; pre‐eclampsia; Risk factors; Ventricular Dysfunction, Left - physiopathology
• ISSN: 1470-0328; 1471-0528
• DOI: 10.1111/j.1471-0528.2010.02780.x

Please cite this paper as: Strobl I, Windbichler G, Strasak A, Weiskopf‐Schwendinger V, Schweigmann U, Ramoni A, Scheier M. Left ventricular function many years after recovery from pre‐eclampsia. BJOG 2011;118:76–83. Objective  Epidemiological observations have shown that women with pre‐eclampsia are at increased risk for subsequent development of cardiovascular disease. We evaluated maternal haemodynamics in asymptomatic women many years after pre‐eclampsia and HELLP (haemolysis, elevated liver enzymes and low platelets) syndrome. Design  Case–control study. Setting  University‐based department of obstetrics. Population  Forty‐eight women, 13–18 years after the affected pregnancy: 17 women with a history of HELLP syndrome, 14 women with a history of pre‐eclampsia and 17 women following normal pregnancy (control group). Methods  Echocardiographic examination was performed in all groups, recording the isovolumetric contraction time and isovolumetric relaxation time (ICT + IVRT), ejection time (ET), myocardial performance index (MPI), transmitral early to atrial filling velocity ratio (MV‐E/MV‐A), stroke volume (SV) and cardiac output (CO). Main outcome measures  Cardiac function. Results  Women with previous HELLP syndrome showed a significantly increased MPI (0.34 versus 0.26; P = 0.008) and ICT + IVRT (442.16 versus 415.03; P = 0.01); MV‐E/A, SV, ET and CO were not significantly different. Women with a history of pre‐eclampsia showed a significantly increased MPI (0.36 versus 0.26; P = 0.006) and decreased ET (317.3 versus 328.93; P = 0.04); ICT + IVRT, MV‐E/A, SV and CO were not significantly different. Conclusion  This study confirms epidemiological observations that women with pre‐eclampsia are at increased risk for subsequent development of cardiovascular disease. Many years after HELLP syndrome or pre‐eclampsia, asymptomatic women have an increased risk for impaired cardiac function as shown by an increased MPI.