A Multimarker Model for Aberrant Cardiac Geometry after Preeclampsia

Abstract

One out of four women with a history of preeclampsia shows abnormal cardiac remodeling consistent with subclinical heart failure (HF) in the first decade postpartum. Since these women are susceptible for developing remote symptomatic HF, development of a model for aberrant cardiac geometry as a first screening tool after delivery, is urgently needed. In this cross-sectional study, 752 preeclamptic women were included. Cardiovascular evaluation was conducted between six months and five years postpartum including cardiac ultrasound, systolic and diastolic blood pressure (SBP and DBP), plasma volume (PV) and biomarker assessment. We developed a multimarker model using uni-and multivariable linear regression and used the regression coefficients (RC) to develop a formula and estimate the aberrant cardiac remodeling in our population. Both SBP and PV were shown to be independently correlated with relative wall thickness (RWT) and left ventricular mass index (LVMi). C-reactive protein (CRP) and uric acid were independently correlated with RWT. Fibrinogen did not relate to either LVMi or RWT. This study displays markers of abnormal cardiac remodeling in former preeclamptic women, suggesting a combination of mechanical and biochemical factors that should be involved in worrisome chamber remodeling before clinical symptoms arise.