Maternal cardiovascular hemodynamics in preeclampsia: Echocardiographic assessment and evaluation of subclinical left ventricular dysfunction

Abstract

Background: Preeclampsia is a disorder of pregnancy having an impact on multiple organ systems. Cardiac manifestations in preeclampsia are varied which can be easily studied by echocardiography. With the advancement in the field of strain imaging, we can also analyze and predict the subclinical left ventricular dysfunction in these patients which may help us to assess high-risk groups. Objective: To compare maternal cardiovascular hemodynamics and function with emphasis on diastolic parameters and strain imaging using echocardiography in normal pregnant women with those having preeclampsia in the third trimester of pregnancy. Methods: Thirty preeclamptic women and 30 women with a normal singleton pregnancy of 34 weeks gestation were compared for systolic and diastolic parameters on echocardiography. Strain imaging was done to find the global and circumferential strain. Results: Blood pressure and total vascular resistance were significantly more in preeclamptic subjects than control. Women with preeclampsia had more diastolic dysfunction than those having a normal pregnancy. The global longitudinal strain was less in the preeclamptic group (–15.63 ± 1.69) than control (–20.86 ± 1.52). Similarly, the circumferential strain was lower in the preeclamptic group (–16.93 ± 1.11) than control (–21.76 ± 1.25). Conclusion: Preeclamptic women have a significant difference in systolic and diastolic dysfunction as compared to pregnant females having normal blood pressure. Early assessment of these parameters may help to identify the high-risk groups. Knowledge of these changes may help us to understand better the pathophysiological basis of disease which may further help in managing these patients.