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

Abstract

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.

Right‐heart dysfunction in women with congenital heart disease and pre‐eclampsia

“…This association was identified in women with corrected tetralogy of Fallot 2 or aortic coarctation 3 , in whom abnormal right‐heart function was demonstrable before conception on both cardiosonography 4 and cardiac magnetic resonance imaging 5 . Right‐heart dysfunction is an intrinsic feature of pre‐eclampsia 6,7 , as is venous hemodynamic dysfunction 8,9 . It is well known that pre‐eclampsia is a risk factor for cardiovascular disease later in life 10 .…”