Cardiac diastolic function after recovery from pre-eclampsia

Soma-Pillay, Priya; Louw, Melanie; Adeyemo, Adelola; Makin, J.D.; Pattinson, Robert Clive

doi:10.5830/cvja-2017-031

Cited by 18 publications

(14 citation statements)

References 40 publications

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“…In our meta-analysis, BMI (19,(21)(22)(23)25,26,29,31,32) showed statistical significance (pp0.0001), consistent with recent findings (3,32) reporting a two-fold increase in the risk of diabetes in women with PE, as well as increased hypertension and serum glucose and lipid levels. Total cholesterol (21,23,25,29,31,32) and LDL (21,23,25,29,31,32) concentrations were higher in the control group, although the differences were not statistically significant.…”

Section: ' Discussionsupporting

confidence: 92%

“…Our meta-analysis identified the following six significant and consistent factors among PE patients: higher SBP (19,(21)(22)(23)25,26,29), higher DBP (19,(21)(22)(23)25,26,29), higher blood insulin value, which is indicative of future diabetes development (21,23,25,29); and higher HDL, LDL, and insulin levels. These results agree in part with those in recent literature, including the meta-analyses by de Groot et al 35) used another approach comparing the quality of assessment and accuracy and specificity in women with PE and other hypertensive diseases in pregnancy.…”

Section: ' Discussionmentioning

confidence: 86%

“…Among the cardiovascular diseases that developed after PE that were reported in our selected articles, the most prevalent was hypertension ( 18 - 26 , 30 - 32 ), followed by diabetes ( 18 , 20 , 21 , 24 - 28 , 30 , 31 ), and heart failure ( 18 , 19 , 22 , 23 , 26 , 27 , 30 , 31 ). Stroke and brain diseases also occurred in some patients a few years after the incidence of PE ( 18 , 23 , 24 , 27 , 31 ), as well as coronary artery calcification in some women ( 21 , 29 ) ( Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Previous preeclampsia and its association with the future development of cardiovascular diseases: a systematic review and meta-analysis

Veiga¹,

Rocha²,

Caviola³

et al. 2021

Clinics

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Preeclampsia is a multifactorial disease. Among these factors, untreated hypertension during pregnancy can result in high morbidity and mortality rates and may also be related to the future development of cardiovascular diseases.Therefore, this systematic review aimed to determine the association of previous preeclampsia with the future development of cardiovascular diseases. Studies on the association between preeclampsia and future cardiovascular diseases published in the last 10 years (2009-2019) were identified from the PubMed/Medline (207 articles), Embase (nine articles), and Cochrane (three articles) databases using the keywords “preeclampsia” and “future cardiovascular diseases”, “preeclampsia” and “future heart attack”, and “preeclampsia” and “future cardiac disease”. After applying the inclusion and exclusion criteria, 15 articles were analyzed by systematic review and meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The meta-analysis and the determination of the quality of the articles were conducted using RevMan software, version 5.3. Statistically significant differences were observed between the control and previous preeclampsia groups with respect to systolic blood pressure (mean difference [MD] 4.32; 95% confidence interval [95%CI] 3.65, 4.99; p <0.001), diastolic blood pressure (MD): 2.11; 95%CI: 1.68, 2.55; p <0.0001), and insulin level (MD: 2.80; 95% CI: 0.50, 5.11; p <0.001). Body mass index (MD: 2.57, 95%CI: 2.06, 3.07; p =0.0001), total cholesterol (MD: 10.39; 95%CI: 8.91, 11.87; p =0.0001), HDL (MD: 2.83; 95%CI: 2.20, 3.46; p =0.0001), and LDL (MD: 1.77; 95%CI: 0.42, 3.13; p =0.0001) also differed significantly between groups. Thus, the results of the present study showed that women with a history of preeclampsia were more likely to develop cardiovascular disease.

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Section: ' Discussionsupporting

confidence: 92%

Section: ' Discussionmentioning

confidence: 86%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Previous preeclampsia and its association with the future development of cardiovascular diseases: a systematic review and meta-analysis

Veiga¹,

Rocha²,

Caviola³

et al. 2021

Clinics

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“…Similarly, moderate-severe left ventricular (LV) dysfunction and remodeling (according to the EAE/ASE diagnosis and grading of abnormal LV structure and function) were significantly more prevalent in formerly preterm PE women compared with those who had term preeclampsia and controls (3,6). Similarly, Soma-Pillay et al showed that women with early onset PE had an increased risk of diastolic dysfunction at 1 year post-partum (RR 3.41, 95% CI: 1.11-10.5, p = 0.04) and regardless of the presence of chronic hypertension (56). Breetveld et al in their prospective longitudinal cohort study confirmed that the prevalence of HF-B was consistently high (1 in 4) amongst formerly PE women at 1 and 4 years postpartum (41).…”

Section: Asymptomatic Heart Failurementioning

confidence: 88%

Hypertensive Disorders of Pregnancy and Future Cardiovascular Health

Melchiorre

Thilaganathan

Giorgione

et al. 2020

Front. Cardiovasc. Med.

100

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Hypertensive disorders of pregnancy (HDP) occur in almost 10% of gestations. These women are known to have higher cardiovascular morbidity and mortality later in life in comparison with parous controls who had normotensive pregnancies. Several studies have demonstrated that women with preeclampsia present in a state of segmental impaired myocardial function, biventricular chamber dysfunction, adverse biventricular remodeling, and hypertrophy, a compromised hemodynamic state and indirect echocardiographic signs of localized myocardial ischemia and fibrosis. These cardiac functional and geometric changes are known to have strong predictive value for cardiovascular disease in non-pregnant subjects. A "dose effect" response seems to regulate this relationship with severe HDP, early-onset HDP, coexistence of fetal growth disorders, and recurrence of HDP resulting in poorer cardiovascular measures. The mechanism underlying the relationship between HDP in younger women and cardiovascular disease later in life is unclear but could be explained by sharing of pre-pregnancy cardiovascular risk factors or due to a direct impact of HDP on the maternal cardiovascular system conferring a state of increased susceptibility to future metabolic or hemodynamic insults. If so, the prevention of HDP itself would become all the more urgent. Shortly after delivery, women who experienced HDP express an increased risk of classic cardiovascular risk factors such as essential hypertension, renal disease, abnormal lipid profile, and diabetes with higher frequency than controls. Within one or two decades after delivery, this group of women are more likely to experience premature cardiovascular events, such as symptomatic heart failure, myocardial ischemia, and cerebral vascular disease. Although there is general agreement that women who suffered from HDP should undertake early screening for cardiovascular risk factors in order to allow for appropriate prevention, the exact timing and modality of screening has not been standardized yet. Our findings suggest that prevention should start as early as possible after delivery by making the women aware of their increased cardiovascular risk and encouraging weight control, stop smoking, healthy diet, and daily exercise which are well-established and cost-effective prevention strategies.

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“…It leads to remodeling of the left ventricle and impaired contractility, resulting in diastolic dysfunction. Pre-eclampsia and other hypertensive disorders are known to be one of the five leading causes of maternal death worldwide and Pre-eclampsia increases the risk of future hypertension, ischemic heart disease, venous thromboembolism, and stroke [11]. We also known that it preserved the systolic function of the left ventricle in cases of preeclampsia, no matter how severe it is [12].…”

Section: Discussionmentioning

confidence: 99%

Association of Peripartum Cardiomyopathy with Pre-eclampsia and Maternal Outcome

Abbas

Yousfani

Shaikh

et al. 2021

JPRI

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Objective: To determine the Prevalence of Pre-eclampsia in women with peripartum cardiomyopathy (PPCM) and to compare the maternal outcome in cases of PPCM who develop pre-eclampsia with those cases who are normotensive. Study design: This is a prospective observational study. Setting: Study carried out at department of Gynecology and Obstetrics, Liaquat university hospital Hyderabad from 20th February 2019 to 19th February 2020. Materials and methods: This prospective observational study was conducted in department of Gynecology and Obstetrics and department of Cardiology Liaquat University Hospital Hyderabad. Inclusion criteria were patients admitted with a diagnosis of peripartum cardiomyopathy diagnosed clinically and confirmed by echocardiography. Exclusion criteria were cases with multiple pregnancies, smokers, those with chronic hypertension and chronic renal disease or diabetes. We assessed patients for pre-eclampsia. Outcome measures studied were serious maternal complications like Pulmonary oedema, Cardiogenic shock, intensive care unit admission, and death. Results: During one year study period, there were 71 cases of peripartum cardiomyopathy. The mean age of patients was 29.77±6.8 years. Pre-eclampsia was seen in 62% cases of Peripartum cardiomyopathy. Mean ejection fraction was 33.24±6.49. In patients of PPCM, serious maternal complications including cardiogenic shock 11(15.5%) cases, intensive care unit admission 10(14.1%) cases, pulmonary oedema 35(49.3%) cases and prolonged hospitalization 58(81.7%) cases. Conclusion: We conclude that pre-eclampsia has high prevalence in patients with PPCM. Both when combined, significantly increase the chances of serious maternal complications including death.

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Cardiac diastolic function after recovery from pre-eclampsia

Cited by 18 publications

References 40 publications

Previous preeclampsia and its association with the future development of cardiovascular diseases: a systematic review and meta-analysis

Previous preeclampsia and its association with the future development of cardiovascular diseases: a systematic review and meta-analysis

Hypertensive Disorders of Pregnancy and Future Cardiovascular Health

Association of Peripartum Cardiomyopathy with Pre-eclampsia and Maternal Outcome

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