Severe Preeclampsia is Associated with Functional and Structural Cardiac Alterations: A Case-control Study

Abstract

Background The aim of the current study is to compare electrocardiographic and echocardiographic changes in patients with severe preeclampsia (PE) and those with uncomplicated pregnancies. Methods This is a case-controlled prospective study consisting of 21 pregnant women with severe preeclampsia and a control group consisting of age- and gestational age-matched 24 healthy pregnant women. All patients underwent electrocardiographic and echocardiographic investigation. Results QRS intervals were shorter and PR intervals were longer in the PE group (QRS duration: 80 (60–120) ms and 80 (40–110) ms, p=0.035; PR duration: 160 (100–240) ms and 120 (80–200) ms, respectively; p=0.046). The left ventricular end-systolic diameters of the patients with severe PE group were significantly larger than the control group (31 (24–36) mm and 30 (24–33) mm, respectively; p=0.05). Similarly, posterior wall thickness values of the PE group were significantly higher compared to the control group (9 (7–11) mm vs. 8 (6–10) mm, respectively; p=0.020). Left ventricular mass (146.63±27.73 g and 128.69±23.25 g, respectively; p=0.033) and relative wall thickness values (0.385±0.054 and 0.349±0.046, respectively; p=0.030) were also higher in the PE group. In addition, patients with early-onset severe PE had significantly a higher left ventricular end-diastolic diameter and volume compared with late-onset PE patients. Conclusions The structural changes detected in the severe PE group suggest a chronic process rather than an acute effect. In addition, diastolic dysfunction and left ventricular remodeling are most marked in patients with severe early-onset PE.

CD97 expression level and its effect on cell adhesion in Preeclampsia

“…Uric acid and LDH as essential biomarkers, which have prognostic importance for the severity of preeclampsia, were observed in accordance with the literature [33].…”

“…Uric acid and LDH as essential biomarkers, which have prognostic importance for the severity of preeclampsia, were observed in accordance with the literature [ 33 ]. As well as the impacts of these fundamental biomarkers, both mesenchymal markers like N-cadherin and epithelial markers like E-cadherin have roles in EMT.…”

CD97 Expression Level and Its Effect on Cell Adhesion in Preeclampsia

“…Uric acid and LDH as essential biomarkers, which have prognostic importance for the severity of preeclampsia, were observed in accordance with the literature [33]. As well as the impacts of these fundamental biomarkers, both mesenchymal markers like N-cadherin and epithelial markers like Ecadherin have roles in EMT.…”

Echocardiographic Differences in Women Across Subtypes of Hypertensive Disorders of Pregnancy

“… d β = regression coefficient from a linear regression model adjusted for age, body mass index, race, smoking status, gestational diabetes, and nongestational diabetes.

Central Illustration Echocardiographic Changes in Women Across Different Subtypes of Hypertensive Disorders of Pregnancy 15 LAVi = left atrial volume index; LV = left ventricular; LVMi = left ventricular mass index; RWT = relative wall thickness; TR = tricuspid regurgitation.

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“…For those with SPE and PRE, we examined whether they developed severe features based on systolic BP ≥160 mm Hg, diastolic BP ≥110 mm Hg, or evidence of end-organ dysfunction such as elevated liver function tests, thrombocytopenia, neurologic symptoms, pulmonary edema, or worsening renal function. 15 The Institutional Review Board of Allegheny Health Network approved the study protocol.…”