Quantitative analysis of left atrial myocardial function and compliance in patients with pre-eclampsia

Abstract

Background: Pre-eclampsia (PE) is a severe obstetric complication associated with many cardiovascular disorders. Left atrial (LA) function and its relevance to the cardiovascular adaptation changes associated with PE have not been adequately addressed. The aim of this study was to quantify LA myocardial deformation characteristics in women with PE using speckle tracking echocardiography (STE). Methods: Using STE, LA global longitudinal strain (LAGLS), phasic LA strain values and LASr/(E/e'), which was the value of LA reservoir strain (LASr) divided by the quotient of early mitral flow velocity (E) and diastolic mitral ring velocity (e'), were compared among nonpregnant controls (n=39), normotensive pregnant women (n=40), and PE (n=43) patients. Results: LAGLS, LASr and LA conduit strain reduced in PE group in spite of no difference of LA contraction strain among the three groups. LASr/(E/e'), the surrogate of LA compliance, was decreased during PE pregnancy. The multivariate regression analyses showed LAGLS was independently correlated with LASr/(E/e'), left ventricular global longitudinal strain and LA maximum volume. Conclusion: PE cases undergo impaired LA myocardial function and decreased atrial compliance. STE-derived LA strain may be a powerful diagnostic parameter to evaluate diastolic function with the progression of PE pregnancy.