Early-onset preeclampsia predisposes to preclinical diastolic left ventricular dysfunction in the fifth decade of life: An observational study

Bokslag, Anouk; Franssen, Constantijn; Alma, Lisa J.; Kovačević, Igor; Kesteren, Floortje van; Teunissen, Pim W.; Kamp, Otto; Ganzevoort, Wessel; Hordijk, Peter L.; Groot, Christianne de; Paulus, Walter J.

doi:10.1371/journal.pone.0198908

Cited by 40 publications

(45 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…13 An alternative proposed by Wu et al is that pre-eclampsia unmasks early cardiovascular disease, a failure of the pregnancy 'stress test'. One is that pre-eclampsia and cardiovascular disease share an aetiology of systemic inflammation, endothelial dysfunction and oxidative stress.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, biventricular systolic dysfunction, severe hypertrophy, left atrial dilatation and global diastolic dysfunction can all be observed in both pre-eclampsia and essential hypertension. 13 Orabona et al specifically excluded from their study women with cardiovascular risk factors (smoking, dyslipidaemia, overweight/obesity, diabetes mellitus, or chronic hypertension) and only included women who had remained normotensive 6 months post-partum. 10 However, the two studies in this review looking at incidence of HF-B post-partum did not find any association between HF-B and hypertension, or other metabolic syndrome constituents.…”

Section: Discussionmentioning

confidence: 99%

“…In 2011, the American Heart Association updated its Guidelines for the Prevention of Cardiovascular disease to include pre-eclampsia as an independent risk factor for cardiovascular disease. 13 28 The Society of Obstetric Medicine Australia and New Zealand (SOMANZ) guidelines also recommends lifestyle modification and risk factor modification for women with a history of pre-eclampsia as well as an annual blood pressure check and regular (5 yearly or more frequent if indicated) assessment of other cardiovascular risk factors including serum lipids and blood glucose.…”

Section: Discussionmentioning

confidence: 99%

“…10,[12][13][14][15][16][17] Right-sided cardiovascular system Persistence of right ventricular (RV) systo-diastolic dysfunction was reported by Melchiorre et al in women with a history of preterm pre-eclampsia, with resolution of changes more likely in term pre-eclampsia. Concentric remodelling was the predominant finding in women with a history of pre-eclampsia, persisting into the post-partum period.…”

Section: Left Ventricular Geometrymentioning

confidence: 99%

“…Increased Left Ventricular Mass Index (LVMI) and increased septal and posterior wall thickness were also demonstrated across several studies, associated with HF-B and with subsequent development of hypertension. 10,[12][13][14][15][16][17] Right-sided cardiovascular system Persistence of right ventricular (RV) systo-diastolic dysfunction was reported by Melchiorre et al in women with a history of preterm pre-eclampsia, with resolution of changes more likely in term pre-eclampsia. Where RV changes were seen, they were in association with advanced LV diastolic dysfunction.…”

Section: Left Ventricular Geometrymentioning

confidence: 99%

See 4 more Smart Citations

Pre‐eclampsia and long‐term cardiac dysfunction: A review of asymptomatic cardiac changes existing well beyond the post‐partum period

Thayaparan

Said

Löwe

et al. 2019

Australas J Ultrason Med

View full text Add to dashboard Cite

Background: Pre-eclampsia is a disease of pregnancy characterised by the manifestations of multi-organ dysfunction. The recent use of transthoracic echocardiography in the assessment of women with pre-eclampsia has allowed the detection of cardiac systolic and diastolic dysfunction in the acute phase. Women with a history of pre-eclampsia also have increased lifelong risks of cardiovascular disease and mortality that persists well beyond the post-partum period. These developments raise the possibility that pre-eclampsia may be an early marker of cardiovascular disease and the potential role for echocardiography in guiding the detection and management of this. This review aims to summarise the existing evidence of echocardiographic cardiac assessment of women with a history of pre-eclampsia performed more than 12 weeks post-partum. Methods: A systematic search of PubMed and OVID EMBASE databases was performed to identify studies featuring assessment of cardiac function performed after 12 weeks post-partum in women with a history of pre-eclampsia. Studies without post-partum cardiac assessment or with other documented causes for cardiomyopathy were excluded. Results: Thirteen studies were identified that measured cardiac function by transthoracic echocardiography between 6 months and 18 years following a pregnancy complicated by pre-eclampsia. Common findings across the studies were of increased diastolic dysfunction, increased left ventricular mass index (LVMI) and concentric hypertrophy in women with a history of preeclampsia, as compared to women with uncomplicated pregnancy histories. This was predominantly seen in those with a history of early or preterm pre-eclampsia. Conclusions: Women with a history of early or preterm pre-eclampsia have an increased prevalence of diastolic dysfunction. This review demonstrates that the cardiac dysfunction associated with previous pre-eclampsia is quantifiable and persistent. Progression of heart failure from asymptomatic to symptomatic stages carries a fivefold increase in mortality. The use of echocardiography could detect cardiac dysfunction in the asymptomatic stage and guide more intensive risk factor modification in these women.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%