Severe preeclampsia associated with right ventricular strain in 39% of women
Women with preeclampsia with severe features (PEC) have higher right ventricular (RV) systolic pressure (RVSP) and decreased global right ventricular longitudinal systolic strain (RVLSS), among other adverse cardiovascular events, compared to women not exhibiting preeclampsia during pregnancy, according to a new study published in the Journal of the American College of Cardiology.
PEC is characterized as systolic blood pressure that is 160 mm Hg or a diastolic blood pressure that is more than or equal to 110 mm Hg measured on two occasions at least four hours apart. It is also characterized as proteinuria, which is more than 300 mg of protein in a 24-hour urine collection or a protein/creatinine ratio of more than 0.3 on urinalysis.
The researchers, led by Arthur Jason Vaught, MD, of Johns Hopkins University School of Medicine in Baltimore, Maryland, sought to characterize the short-term echocardiographic, clinical and laboratory changes in women with PEC. They recruited 63 women with PEC and 36 healthy women for the observational study.
Study results indicated women with severe preeclampsia have elevated RVSP values, diastolic dysfunction, diminished RV strain and abnormal cardiac remodeling when compared with normotensive pregnant control patients.
The researchers found approximately 13 percent of women with PEC had echocardiographic evidence of grade II diastolic dysfunction, 39 percent had abnormal right ventricular strain and approximately 10 percent had peripartum pulmonary edema.
In an associated editorial, the authors, led by Chahinda Ghossein-Doha, MD, PHD, noted that, for the first time, severe preeclampsia has been associated with RV strain.
“The study of Vaught et al. has highlighted again in an elegant way the occult aberrant cardiac adaptation during severe preeclampsia and shows that not only LV diastolic and systolic function may be impaired, but for the first time, also impaired RV longitudinal systolic strain,” they wrote. “It supports the concept that pregnancy should be valued as a sex-specific, women- sensitive CV stress test, and the necessity to use novel methods in order to detect early stage abnormalities in the twilight zone between health and disease.”
Future studies, the editorial authors noted, “should focus on the predictive value of cardiac strain abnormalities in pregnancy outcome, long-term CV outcome and the effect of different antihypertensive drug on normalizing cardiac function and with it, short- and long-term female health prognosis.”
As a senior news writer for TriMed, Subrata covers cardiology, clinical innovation and healthcare business. She has a master’s degree in communication management and 12 years of experience in journalism and public relations.