Subclinical Systolic Dysfunction of the Left Ventricle in Preeclamptic Women Without Proteinuria. The Possibilities of Echocardiography in Early Diagnosis

Abstract

The article presents the main pathophysiological mechanisms associated with the development of complications of pregnancy against the background of arterial hypertension in patients without clinical manifestations of left ventricular dysfunction, the possibilities of speckle tracking of echocardiography in revealing latent systolic dysfunction of the left ventricle in pregnant women on the background of preeclampsia not accompanied by proteinuria are shown.Goal. To identify early markers of left ventricular systolic dysfunction in pregnant women with preeclampsia without proteinuria according to speckle tracking echocardiography.Material and methods. 100 pregnant women with hypertension and a gestation period of 29–40 weeks are divided into 2 groups: 1 st group – 50 patients without an arterial hypertension in the anamnesis, 2 nd group – 50 patients with an arterial hypertension in the anamnesis (without the proteinuria during pregnancy). For all patients, echocardiography with evaluation of cardiomyocyte function by speckle-tracking was performed on ultrasonic scanners Aplio ™ 500 and Aplio ™ Artida from Toshiba.Results. Ejection fraction of the left ventricle in the groups was not significantly different, while the longitudinal, radial and circular deformation parameters differed between the groups, with the lowest values characterizing the global longitudinal deformation.Conclusions. In assessing the function of the left ventricle in pregnant women with preeclampsia without diurnal proteinuria, it is not enough to focus on traditional parameters, shifting the emphasis towards derivatives of force, speed and time. Study of myocardium with the help of speckle tracking echocardiography promotes the detection of subclinical left ventricular dysfunction in patients with arterial hypertension without daily proteinuria.