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Maternal left ventricular hypertrophy and diastolic dysfunction and brain natriuretic peptide concentration in early‐ and late‐onset pre‐eclampsia
Author(s) -
Borges V. T. M.,
Zanati S. G.,
Peraçoli M. T. S.,
Poiati J. R.,
RomãoVeiga M.,
Peraçoli J. C.,
Thilaganathan B.
Publication year - 2018
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.17495
Subject(s) - medicine , cardiology , brain natriuretic peptide , left ventricular hypertrophy , diastole , concentric hypertrophy , body mass index , natriuretic peptide , gestation , mass index , muscle hypertrophy , heart failure , pregnancy , endocrinology , blood pressure , genetics , biology
ABSTRACT Objective Pre‐eclampsia (PE) is associated with maternal cardiac remodeling and diastolic dysfunction. The aim of this study was to assess and compare maternal left ventricular structure and diastolic function and levels of brain natriuretic peptide (BNP) in women with early‐onset (< 34 weeks' gestation) vs those with late‐onset (≥ 34 weeks' gestation) PE. Methods This was a prospective, cross‐sectional, observational study of 30 women with early‐onset PE, 32 with late‐onset PE and 23 normotensive controls. Maternal cardiac structure and diastolic function were assessed by echocardiography and plasma levels of BNP were measured by enzyme immunoassay. Results Early‐ and late‐onset PE were associated with increased left ventricular mass index and relative wall thickness compared with normotensive controls. In women with early‐onset PE, the prevalence of concentric hypertrophy (40%) and diastolic dysfunction (23%) was also significantly higher (both P < 0.05) compared with women with late‐onset PE (16% for both). Maternal serum BNP levels were significantly higher ( P < 0.05) in women with early‐onset PE and correlated with relative wall thickness and left ventricular mass index. Conclusions Early‐onset PE is associated with more severe cardiac impairment than is late‐onset PE, as evidenced by an increased prevalence of concentric hypertrophy, diastolic dysfunction and higher levels of BNP. These findings suggest that early‐onset PE causes greater myocardial damage, increasing the risk of both peripartum and postpartum cardiovascular morbidity. Although these cardiovascular effects are easily identified by echocardiographic parameters and measuring BNP, further studies are needed to assess their clinical utility. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.