Cardiovascular Implications in Preeclampsia

Melchiorre, K.; Sharma, Rajan; Thilaganathan, B.

doi:10.1161/circulationaha.113.003664

Cited by 255 publications

(211 citation statements)

References 88 publications

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“…There is growing evidence of an asymptomatic left ventricular systolic and diastolic dysfunction, left ventricular hypertrophy, and prehypertension state 1-year postpartum in patients with previous early preeclampsia, 18,36 and 40% of patients with persistent cardiac alterations develop essential hypertension within 2 years after early preeclampsia. Estensen et al 37 demonstrated a higher resistance throughout the arterial system persisting over time in women with a previous preeclampsia.…”

Section: Discussionmentioning

confidence: 99%

Persistent Maternal Cardiac Dysfunction After Preeclampsia Identifies Patients at Risk for Recurrent Preeclampsia

et al. 2016

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Maternal cardiovascular health represents the key point for developing an uneventful pregnancy, and its proper function is important for a normal evolution of pregnancy. Serious pregnancy-related hypertensive disorders such as preeclampsia might entail severe future effects on women's health even after delivery and influence the long-term quality of life as well as the following pregnancy outcomes. A proper maternal cardiovascular adaptation to the pregnancy plays a key role for preventing gestational hypertensive complications, such as preeclampsia. [1][2][3][4][5] Preeclampsia affects the 3% to 8% of pregnancies and represents a cause of increased maternal and perinatal morbidity and mortality. 6,7 According to the different onset time, the origin and hemodynamics, preeclampsia is classified as early (placental mediated, linked to defective trophoblast invasion with high incidence of altered uterine artery Doppler, and lower body mass index [BMI]) and late (related to higher BMI and no alteration of uterine artery Doppler) 8 recurring in 15% of the following pregnancies.9-11 Former preeclamptics have a 7× higher risk of disease recurrence compared with women who have had a normal pregnancy. 12,13Patients with a previous preeclampsia show maternal cardiac dysfunction, and they are more likely to develop systemic hypertension and to die at an early age from cardiovascular disease. [14][15][16][17] In particular, postpartum follow-up of women with a previous preeclampsia showed persistence of altered cardiac geometry and left ventricular dysfunction. 18,19 The latest studies in literature highlight the importance of assessing maternal cardiac function and structure evaluating hemodynamics in terms of total vascular resistance (TVR), left ventricular geometric pattern with regard to the presence of concentric geometry, and diastolic dysfunction. [20][21][22] It is of primary importance to understand how to select and identify those women at increased risk for recurrent preeclampsia. In a recent study, Scholten et al 23 concluded that the risk of recurrent preeclampsia and fetal growth restriction in a subsequent pregnancy is inversely and linearly related to pregnancy plasma volume, and this condition might predispose to abnormal hemodynamic adaptation to pregnancy. In previously early preeclamptic women, given the high incidence of postpartum asymptomatic left ventricular abnormalities, the high See Editorial Commentary, pp 690-692Abstract-The purpose of our study was to assess cardiac function in nonpregnant women with previous early preeclampsia before a second pregnancy to highlight the cardiovascular pattern, which may take a risk for recurrent preeclampsia. Seventy-five normotensive patients with previous preeclampsia and 147 controls with a previous uneventful pregnancy were enrolled in a case-control study and submitted to echocardiographic examination in the nonpregnant state 12 to 18 months after the first delivery. All patients included in the study had pregnancy within 24 months from the echocardiograp...

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Section: Discussionmentioning

confidence: 99%

Persistent Maternal Cardiac Dysfunction After Preeclampsia Identifies Patients at Risk for Recurrent Preeclampsia

et al. 2016

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“…It is one of the leading causes of maternal morbidity and mortality worldwide, and delay in the treatment of severe hypertension and diagnosis of pre-eclampsia complications contribute significantly to maternal mortality. 5 Multiple exceptional and exclusive changes in cardiac structure and function have been described in pre-eclampsia, suggesting that these women display abnormal cardiac adaptation to pregnancy and hence towards long-term postpartum cardiovascular disease (CVD). The development of pre-eclampsia and eclampsia is now considered a risk factor for long-term CVD.…”

Section: 2mentioning

confidence: 99%

“…The development of pre-eclampsia and eclampsia is now considered a risk factor for long-term CVD. 5 The data on changes in diastolic function in pregnancy induced hypertension is limited and studies have reported varying levels of diastolic function across various stages of gestation. 10 Therefore,this study was undertaken to assess changes in diastolic function in pregnancy induced hypertension and compared to normal pregnant women by 2D echocardiography and Doppler evaluation.…”

Section: 2mentioning

confidence: 99%

Evaluation of Left Ventricular Diastolic Function in Pregnancy Induced Hypertension and Its Comparison With Normotensive Pregnant Asian Indian Females.

Patted¹,

Porwal²,

Halkati³

et al. 2017

IJAR

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“…73 It is possible that products of the dysfunctional placenta in preeclampsia could permanently compromise the maternal cardiovasculature. 73,74 These could include inflammatory molecules in general as well as factors that perturb maternal angiogenic balance: increased circulating sFlt1 and soluble endoglin and reduced placental growth factor (PlGF), as well as unmeasurable low levels of free vascular endothelial growth factor during pregnancy. 75 Although sFlt1 falls rapidly after delivery, a modest dysregulation several months and years after a preeclamptic pregnancy has been described.…”

Section: Staff Et Al Pregnancy and Long-term Cvd Research Harmonizatimentioning

confidence: 99%

“…These changes were more severe and more frequent when associated with preterm, rather than term preeclampsia. 85 The long-term CVD outcome remains unknown, 74 but as diastolic dysfunction is recognized to predate heart failure and increased mortality, 86,87 poor long-term cardiovascular health is likely.…”

Section: Staff Et Al Pregnancy and Long-term Cvd Research Harmonizatimentioning

confidence: 99%

Pregnancy and Long-Term Maternal Cardiovascular Health

et al. 2016

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Cardiovascular Implications in Preeclampsia

Cited by 255 publications

References 88 publications

Persistent Maternal Cardiac Dysfunction After Preeclampsia Identifies Patients at Risk for Recurrent Preeclampsia

Persistent Maternal Cardiac Dysfunction After Preeclampsia Identifies Patients at Risk for Recurrent Preeclampsia

Evaluation of Left Ventricular Diastolic Function in Pregnancy Induced Hypertension and Its Comparison With Normotensive Pregnant Asian Indian Females.

Pregnancy and Long-Term Maternal Cardiovascular Health

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