Assessment of right heart function in preeclampsia by echocardiography

Çağlar, Fatma Nihan Turhan; Özde, Cem; Bostancı, Evrim; Caglar, Ilker Murat; Ciftci, Serkan; Ünğan, İsmail; Demir, Bülent; Karakaya, Osman

doi:10.1016/j.preghy.2015.12.004

Cited by 22 publications

(28 citation statements)

References 23 publications

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“…Noninvasive assessment of the pulmonary circulation and RV function and structure in PEC is an evolving area of investigation. We are aware of only two studies assessing PA flow dynamics noninvasively in PEC, and both of those studies corroborate our findings in general, although by using a slightly different methodology (without distinguishing between early-and late-onset PEC and without excluding patients with severe PEC) [17,18]. Significantly, although the gold standard for diagnosing PAH is right heart catheterization, it is invasive and increases the risk of maternal and fetal radiation exposure, and is associated with a greater risk of tachyarrhythmias, infection, pulmonary infarction, and PA rupture.…”

Section: Discussionsupporting

confidence: 86%

“…In our early PEC cohort, we found the estimated MPAP to be above the maximum of the normal range. Both Çağlar et al [17] and Vaught et al [18] have found significantly increased estimated PA pressures in preeclamptic patients, but their reported values were below or at the limit of maximum normal pressure (20 mmHg). The difference could be methodological since they used TV regurgitant jet velocity for their estimate, and we based our estimate on PAAT.…”

Section: Discussionmentioning

confidence: 92%

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Noninvasive Assessment of Right Ventricle Function and Pulmonary Artery Pressure Using Transthoracic Echocardiography in Women With Pre-Eclampsia: An Exploratory Study

Zaky¹,

Froelich²,

Meers³

et al. 2021

Cureus

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Background and objective Pre-eclampsia (PEC) is associated with the release of anti-angiogenic factors that are incriminated in raising systemic and pulmonary vascular resistance (PVR). Compared to the left heart and systemic circulation, much less attention has been paid to the right heart and pulmonary circulation in patients with PEC. We used transthoracic echocardiography (TTE) to estimate pulmonary artery (PA) pressure and right ventricular (RV) function in women with PEC. Materials and methods We conducted a case-control study at a tertiary care academic center. Ten early PEC (<34-week gestation) and nine late PEC (≥34-week gestation) patients with 11 early and 10 late gestational age-matched controls were enrolled. Two-dimensional TTE was performed on all patients. The estimated mean PA pressure (eMPAP) was calculated based on PA acceleration time (PAAT). PVR was estimated from eMPAP and RV cardiac output (RV CO). RV myocardial performance index (RV MPI), tricuspid annular plane systolic excursion (TAPSE), tissue tricuspid annular displacement (TTAD), and lateral tricuspid annular tissue peak systolic velocity (S') were measured.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 92%

Noninvasive Assessment of Right Ventricle Function and Pulmonary Artery Pressure Using Transthoracic Echocardiography in Women With Pre-Eclampsia: An Exploratory Study

Zaky¹,

Froelich²,

Meers³

et al. 2021

Cureus

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“…To the best of our knowledge, no previous studies have evaluated f-TAPSE in fetuses of pregnant women with DM. Recently, Çağlar et al 32 compared 67 pregnant women with untreated preeclampsia (PE) and 46 healthy controls and found significantly lower values for f-TAPSE in the pregnant women with untreated PE. Cruz-Lemini et al 31 compared f-TAPSE using the conventional real-time M-mode and tissue Doppler imaging to assess cardiac dysfunction in fetuses with IUGR.…”

Section: Discussionmentioning

confidence: 99%

Fetal Heart Function by Tricuspid Annular Plane Systolic Excursion and Ventricular Shortening Fraction Using STIC M-Mode: Reference Ranges and Validation

et al. 2017

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Objective To determine the reference values for fetal tricuspid annular plane systolic excursion (f-TAPSE) and fetal ventricular shortening fraction (f-VSF) using spatiotemporal image correlation (STIC) with M-mode, and validate these curves in fetuses of pregnant women with preexisting diabetes mellitus (DM) and with intrauterine growth restriction (IUGR). Study Design Crosssectional study assessed 300 fetal cardiac volumes of normal pregnancies between 20 and 33 + 6 weeks of gestation. For the construction of the reference curves, we used a polynomial regression model adjusted with the coefficient of determination (R2). For the calculation of reproducibility, the concordance correlation coefficient (CCC) was used. Results f-TAPSE value correlated with gestational age (GA, R2 = 0.46), whereas fetal right ventricular shortening fraction (f-RVSF, R2 = 0.02) and fetal left ventricular shortening fraction (f-LVSF, R2 = 0.005) did not vary with GA. Fetuses of pregnant women with preexisting DM (30) had lower values of f-RVSF (p = 0.028), f-LVSF (p = 0.001), and f-TAPSE (p = 0.009) than normal fetuses. The f-TAPSE values were lower (p = 0.005) in IUGR group (17). The f-TASPSE values showed adequate reliability as well as good intra and interobserver concordance (CCC = 0.95 and 0.79, respectively). Conclusion The reference ranges for f-TAPSE, f-RVSF, and f-LVSF using the STIC M-mode were established and had good reproducibility for f-TAPSE measurements.

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“…), and are not only restricted to the left side but also present in the right ventricle (Çağlar et al . ; Buddeberg et al . ).…”

Section: Cardiovascular and Renal Characteristics Of Preeclampsiamentioning

confidence: 99%

“…In the second trimester, echocardiographic abnormalities are already present (Valensise et al 2008a,b), but diastolic dysfunction is observed in early, but not late preeclampsia (Melchiorre et al 2016) -suggesting that diastolic dysfunction of late preeclampsia develops during the second half of pregnancy as a consequence of chronic volume overload (Valensise et al 2008a,b;Melchiorre et al 2016). Importantly, in both early-and late-onset preeclampsia, cardiac morphological changes such as adverse ventricular remodelling and increase in left ventricular mass precede the onset of chamber dysfunction (Cong et al 2015), and are not only restricted to the left side but also present in the right ventricle (Ç aglar et al 2016;Buddeberg et al 2018a).…”

Section: Cardiorenal Interactions and Their Effect On Placental Permentioning

confidence: 99%

Preeclampsia: a gestational cardiorenal syndrome

Gyselaers

Thilaganathan

2019

The Journal of Physiology

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It is generally accepted today that there are two different types of preeclampsia: an early‐onset or placental type and a late‐onset or maternal type. In the latent phase, the first one presents with a low output/high resistance circulation eventually leading in the late second or early third trimester to an intense and acutely aggravating systemic disorder with an important impact on maternal and neonatal mortality and morbidity; the other type presents initially as a high volume/low resistance circulation, gradually evolving to a state of circulatory decompensation usually in the later stages of pregnancy, with a less severe impact on maternal and neonatal outcome. For both processes, numerous dysfunctions of the heart, kidneys, arteries, veins and interconnecting systems are reported, most of them presenting earlier and more severely in early‐ than in late‐onset preeclampsia; however, some very specific dysfunctions exist for either type. Experimental, clinical and epidemiological observations before, during and after pregnancy are consistent with gestation‐induced worsening of subclinical pre‐existing chronic cardiovascular dysfunction in early‐onset preeclampsia, and thus sharing the pathophysiology of cardiorenal syndrome type II, and with acute volume overload decompensation of the maternal circulation in late‐onset preeclampsia, thus sharing the pathophysiology of cardiorenal syndrome type 1. Cardiorenal syndrome type V is consistent with the process of preeclampsia superimposed upon clinical cardiovascular and/or renal disease, alone or as part of a systemic disorder. This review focuses on the specific differences in haemodynamic dysfunctions between the two types of preeclampsia, with special emphasis on the interorgan interactions between heart and kidneys, introducing the theoretical concept that the pathophysiological processes of preeclampsia can be regarded as the gestational manifestations of cardiorenal syndromes.

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Assessment of right heart function in preeclampsia by echocardiography

Cited by 22 publications

References 23 publications

Noninvasive Assessment of Right Ventricle Function and Pulmonary Artery Pressure Using Transthoracic Echocardiography in Women With Pre-Eclampsia: An Exploratory Study

Noninvasive Assessment of Right Ventricle Function and Pulmonary Artery Pressure Using Transthoracic Echocardiography in Women With Pre-Eclampsia: An Exploratory Study

Fetal Heart Function by Tricuspid Annular Plane Systolic Excursion and Ventricular Shortening Fraction Using STIC M-Mode: Reference Ranges and Validation

Preeclampsia: a gestational cardiorenal syndrome

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