Observation of changes in left atrial and left ventricular function in patients with hypertensive disorders of pregnancy based on myocardial strain

Abstract

Background: To observe the changes of left atrial and left ventricular function in patients with hypertensive disorders of pregnancy (HDP) based on myocardial strain.Methods: A total of 66 HDP patients admitted to our hospital were retrospectively analyzed, and 36 normal pregnant admitted during the same period women were selected as the control group. The maximum volume of the left atrium (LAV max ), minimum volume of the left atrium (LAV min ), left atrial active ejection fraction (LAAEF), mitral ratio of peak early to late diastolic filling velocity (E/A), and left ventricular active ejection fraction (LVEF) were measured by conventional echocardiography. The peak systolic strain rate (SRs) of each wall of the left atrium during early systole (SRe) and late diastole (SRa) was detected by speckletracking imaging (STI). The longitudinal (LS), radial (RS), and circumferential strain (CS) parameters of each wall of the left ventricle were also measured. The above parameters were compared between the two groups, and the correlation between mean SRa (mSRa) and LAAEF as well as left ventricular global longitudinal strain (GLS) and LVEF in HDP patients was analyzed.Results: LAV max , LAV min , and LAAEF in the HDP group were higher than those in the control group, while the E/A ratio was lower than that in control group (all P<0.05). However, there was no significant difference in LVEF between the two groups (P>0.05). In the HDP group, the absolute values of SRs and SRe in each wall of the left atrium were lower than those in the control group, while the absolute values of SRa were higher than those in the control group. In addition, the absolute values of LS, CS, and RS values in each wall of left ventricle in the HDP group were lower than those in the control group (all P<0.05). Pearson correlation analysis showed that mSRa was negatively correlated with LAAEF (r=−0.895, P=0.000) and that left ventricular long-axis GLS was negatively correlated with LVEF (r=−0.646, P=0.000) in HDP patients.Conclusions: According to the STI results, HDP patients experience significant left atrial and left ventricular myocardial strain injury. Therefore, monitoring of cardiac function and early intervention should be strengthened in clinical practice.

Left atrial structure and function: association with blood pressure variability in pregnant women

“…They reported that the absolute values of peak longitudinal strain rate of systole and the peak longitudinal strain rate of early diastole in each wall of the LA in the HDP group were lower than those of the control group, and the absolute values of the peak longitudinal strain rate of late diastole were higher than those of the control group. In addition, they revealed that LAVmax and LAVmin values were higher in HDP group compared with control group [4]. In our study, there was no difference in LA volumetric analysis between the high BPV group and the low BPV group.…”

“…Recently, Liu et al . [4] examined changes in LA and LV function with myocardial strain in patients with HDP and found that HDP patients had significant LA and LV myocardial strain injury compared with healthy pregnant women. However, unlike our study, BPV was not taken into account in this study.…”

“…Therefore, unlike previous research on BPV in pregnant women, our study provides a more complex and multiparameter analysis that includes detailed comparisons of BPV and LA structure and function. Recently, Liu et al [4] examined changes in LA and LV function with myocardial strain in patients with HDP and found that HDP patients had significant LA and LV myocardial strain injury compared with healthy pregnant women. However, unlike our study, BPV was not taken into account in this study.…”

“…Studies have reported that cardiac structure and function changes may occur in HDP patients in the early stage of the disease [3,4]. The influence of high BP on left ventricular (LV) structure and mechanics was investigated previously and several studies have reported that high BP has a worse effect on LV remodeling in HDP patients [4]. It was also demonstrated that BPV was associated with HDP even after adjustment to average BP levels [5,6].…”