Blood pressure variability correlates with right ventricular strain in women with gestational hypertension and preeclampsia

Tadić, Marijana; Cuspidi, Cesare; Suzić-Lazić, Jelena; Vukomanovic, Vladan; Mihajlovic, Sladjana; Savic, Predrag; Cvrkotic, Marko; Ćelić, Vera

doi:10.1038/s41371-021-00580-x

Cited by 4 publications

(11 citation statements)

References 23 publications

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“…After excluding duplicates (N=172) and ineligible studies at either title/abstract screening (N=100) or full‐text review (N=30), 8 studies reporting on BPV in pregnancy met our inclusion criteria. 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 No eligible study reported on HRV and its association with pregnancy outcomes.…”

Section: Resultsmentioning

confidence: 99%

“…Included articles were published between 2019 and 2022 (Table S3 ). Six studies were from higher‐ to middle‐income countries, 7 , 8 , 10 , 12 , 13 , 14 1 was multicountry from 15 countries of mixed economic levels, 9 and 1 was from 3 low‐income countries. 11 The studies reported on 138 949 participants (median per study, 9433; range, 140–52 891).…”

Section: Resultsmentioning

confidence: 99%

“… 11 The studies reported on 138 949 participants (median per study, 9433; range, 140–52 891). Two studies were cross sectional, 12 , 13 and 6 were retrospective in design, 7 , 8 , 9 , 10 , 11 , 14 including 2 secondary analyses of randomized trials. 9 , 11 Studies included women either throughout pregnancy, 9 , 11 , 14 or focused on the second half of pregnancy 7 , 8 , 10 , 12 , 13 (termed unselected pregnancy cohorts).…”

Section: Resultsmentioning

confidence: 99%

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Blood Pressure and Heart Rate Variability and the Impact on Pregnancy Outcomes: A Systematic Review

Wilson,

Bone,

Mistry

et al. 2024

JAHA

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Background Long‐term (visit‐to‐visit) blood pressure variability (BPV) and heart rate variability (HRV) outside pregnancy are associated with adverse cardiovascular outcomes. Given the limitations of relying solely on blood pressure level to identify pregnancies at risk, long‐term (visit‐to‐visit) BPV or HRV may provide additional diagnostic/prognostic counsel. To address this, we conducted a systematic review to examine the association between long‐term BPV and HRV in pregnancy and adverse maternal and perinatal outcomes. Methods and Results Databases were searched from inception to May 2023 for studies including pregnant women, with sufficient blood pressure or heart rate measurements to calculate any chosen measure of BPV or HRV. Studies were excluded that reported short‐term, not long‐term, variability. Adjusted odds ratios were extracted. Eight studies (138 949 pregnancies) reporting BPV met our inclusion criteria; no study reported HRV and its association with pregnancy outcomes. BPV appeared to be higher in women with hypertension and preeclampsia specifically, compared with unselected pregnancy cohorts. Greater BPV was associated with significantly more adverse pregnancy outcomes, particularly maternal (gestational hypertension [odds ratio range, 1.40–2.15], severe hypertension [1.40–2.20]), and fetal growth (small‐for‐gestational‐age infants [1.12–1.32] or low birth weight [1.18–1.39]). These associations were independent of mean blood pressure level. In women with hypertension, there were stronger associations with maternal outcomes but no consistent pattern for perinatal outcomes. Conclusions Future work should aim to confirm whether BPV could be useful for risk stratification prospectively in pregnancy, and should determine the optimal management path for those women identified at increased risk of adverse outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Blood Pressure and Heart Rate Variability and the Impact on Pregnancy Outcomes: A Systematic Review

Wilson,

Bone,

Mistry

et al. 2024

JAHA

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“…During pregnancies affected by preeclampsia, mild diastolic dysfunction can be detected with standard echocardiographic techniques, but STE can also identify systolic dysfunction [68]. A recent report found that blood pressure variability affects the right ventricle as well [69,70]. Recent data shows that, compared to uncomplicated pregnancies, the ones complicated by preeclampsia affect cardiac function in the long-term, at 10 years post-partum [71].…”

Section: Discussionmentioning

confidence: 99%

Pregnancy Complications Lead to Subclinical Maternal Heart Dysfunction—The Importance and Benefits of Follow-Up Using Speckle Tracking Echocardiography

et al. 2022

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Pregnancy complications such as gestational diabetes (GDM) and hypertensive disorders of pregnancy (HDP) are frequent and influence not only fetal outcomes but also the maternal cardiac function. GDM and HDP may act as a proxy for increased metabolic and cardiovascular risk later in life. Speckle tracking echocardiography (STE) is a relatively new imaging technique that provides more sensitive assessment than conventional echocardiography of the maternal cardiac function. Recent research suggests that STE can be used during pregnancy and postpartum as a useful method of early detection of subclinical maternal cardiac changes related to pregnancy complications, such as GDM and HDP, and as an indicator for future maternal cardiovascular disorders. The aim of this review was to underline the current value of STE in the follow-up protocol of high-risk pregnant women, as a mean for pre- and postpartum monitoring. A review of the literature was conducted in the PubMed database to select relevant articles regarding the association of STE changes and HDP or GDM in the prenatal and postpartum maternal evaluations. Both GDM and HDP are associated with subtle myocardial changes in shape, size and function; these preclinical cardiac changes, often missed by conventional evaluation, can be detected using STE. Left ventricular global circumferential strain might be an important predictor of maternal cardiovascular disorders and might help to define a high-risk group that requires regular monitoring later in life and timely intervention.

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“…This may be related to mineralocorticoid receptor systems and activation of the local angiotensin II (52). In women with pre-eclampsia, BPV was observed to be associated with right ventricular strain (53). In patients with type 2 diabetes, E-selectin, an endothelial-specific molecule involved in vascular inflammation and cardiac metabolism, was positively associated with 24 h diastolic BPV(r = 0.238) and daytime diastolic BPV (r = 0.258) (54).…”

Section: Napping Duration and Bpvmentioning

confidence: 98%

Association between napping and 24-hour blood pressure variability among university students: A pilot study

Dai

Wu²,

Jiang³

et al. 2023

Front. Pediatr.

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BackgroundBlood pressure variability (BPV) has been reported to be a predictor of cardiovascular and some cognitive diseases. However, the association between napping and BPV remains unknown. This study aimed to explore the association between napping and BPV.Materials and methodsA cross-sectional study including 105 university students was conducted. Participants’ 24 h ambulatory blood pressure monitoring (24 h ABPM) were measured, and napping behaviors were investigated. BPV were measured by the 24 h ABPM, included standard deviation (SD), coefficient of variation (CV), and average real variability (ARV).ResultsAmong the participants, 61.9% reported daytime napping. We found that nap duration was significantly associated with daytime CV of diastolic blood pressure (DBP) (r = 0.250, P = 0.010), nighttime CV of systolic blood pressure (SBP) (r = 0.217, P = 0.026), 24 h WCV of DBP (r = 0.238, P = 0.014), 24 h ARV of SBP (r = 0.246, P = 0.011) and 24 h ARV of DBP (r = 0.291, P = 0.003). Compared with the no napping group, 24 h WCV of DBP, daytime CV of DBP, and daytime SD of DBP were significantly higher in participants with napping duration >60 min. With multiple regression analysis we found that nap duration was an independent predictor for 24 h ARV of SBP (β = 0.859, 95% CI, 0.101–1.616, P = 0.027) and 24 h ARV of DBP (β = 0.674, 95% CI, 0.173–1.175, P = 0.009).ConclusionsNapping durations are associated with BPV among university students. Especially those with napping durations >60 min had a significantly higher BPV than those non-nappers.

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Blood pressure variability correlates with right ventricular strain in women with gestational hypertension and preeclampsia

Cited by 4 publications

References 23 publications

Blood Pressure and Heart Rate Variability and the Impact on Pregnancy Outcomes: A Systematic Review

Blood Pressure and Heart Rate Variability and the Impact on Pregnancy Outcomes: A Systematic Review

Pregnancy Complications Lead to Subclinical Maternal Heart Dysfunction—The Importance and Benefits of Follow-Up Using Speckle Tracking Echocardiography

Association between napping and 24-hour blood pressure variability among university students: A pilot study

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