The evaluation of ventricular functions by speckle tracking echocardiography in preeclamptic patients

Int J Cardiovasc Imaging. 2020 Sep;36(9):1689-1694. doi: 10.1007/s10554-020-01872-y. Epub 2020 May 9.

Abstract

Preeclampsia is a maternal disorder of pregnancy characterized by concomitant increase in preload and afterload with end organ dysfunction. The aim of our study is to evaluate left ventricular (LV) and right ventricular (RV) functions with speckle tracking echocardiography in preeclamptic patients. Fifty-five preeclamptic (mean age: 30.7 ± 5.9 years) and 35 healthy pregnant women (mean age: 28.8 ± 5.7 years) of the same race, similar age and gestational week were consecutively included. The diagnosis of preeclampsia was based on the criteria proposed by the American College of Obstetricians and Gynecologists. LV and RV functions were assessed by both conventional and speckle tracking echocardiography after the 30th gestational week and at the postpartum 6th months. The preeclamptic patients had significantly larger left atrium, thicker interventricular septum, higher systolic pulmonary artery pressure and mitral E/e' ratio compared to controls during pregnancy while LV ejection fraction was similar. Preeclamptic patients had significantly lower LV and RV global longitudinal strain (GLS) during pregnancy compared to controls (- 18.0 ± 2.6% vs. - 19.8 ± 2.1% p = 0.001 and - 26.7 ± 3.3% vs. 28.9 ± 3.3% p = 0.002, respectively). In the postpartum period, while LVGLS values of preeclamptic patients increased significantly (- 18.0 ± 2.6% vs. - 20.4 ± 2.4% p < 0.001) and became similar to those of controls at the sixth month, the RVGLS decreased significantly (- 26.7 ± 3.3% vs. - 25.8 ± 2.7% p = 0.003) making the difference in RVGLS between the preeclamptic patients and controls more prominent. Preeclampsia may impair LV and RV function. Long-term follow up with larger sample is needed to determine the clinical relevance of the observed changes in strain.

Keywords: Global longitudinal strain; Left ventricle; Preeclampsia; Right ventricle; Speckle tracking echocardiography.

MeSH terms

  • Adult
  • Case-Control Studies
  • Echocardiography, Doppler, Color*
  • Female
  • Gestational Age
  • Humans
  • Postpartum Period
  • Pre-Eclampsia / diagnostic imaging*
  • Pre-Eclampsia / physiopathology
  • Predictive Value of Tests
  • Pregnancy
  • Recovery of Function
  • Time Factors
  • Ventricular Function, Left*
  • Ventricular Function, Right*
  • Young Adult