Assessment of left ventricular structure and function in preeclampsia by echocardiography and cardiovascular biomarkers.
OBJECTIVE
To assess left ventricular (LV) structure and function in preeclampsia, a serious vascular-related pregnancy disorder, by Doppler tissue imaging (DTI) in combination with the levels of cardiovascular biomarkers.


METHODS
Thirty-five pregnant women with preeclampsia and 30 with normal pregnancy, matched for age and gestational age were examined during pregnancy and 3-6 months after delivery. Transthoracic echocardiography and DTI were performed and blood levels of amino-terminal pro-brain natriuretic peptide (NT-pro-BNP), C-reactive protein (CRP), cystatin C and troponin I were analyzed.


RESULTS
There were significant differences in LV and left atrial dimensions and function between the groups. A higher septal and lateral E/E' ratio (E = early transmitral diastolic flow velocity and E' = early diastolic myocardial velocity) (P < 0.0001, 0.0008) and higher levels of NT-pro-BNP, cystatin C, and lower cystatin C estimated GFR in ml/min per 1.73 m(2) (P < 0.0001) were seen in the preeclampsia both during pregnancy and at follow-up. In addition the levels of E/E' ratio lateral and NT-pro-BNP were higher in pregnant women with early-onset preeclampsia necessitating delivery before 34 weeks of gestation than those who developed preeclampsia and delivered at or after 34 weeks (P = 0.0004, 0.005).


CONCLUSIONS
In pregnancies complicated by preeclampsia, especially early-onset preeclampsia, the diastolic LV function is impaired and levels of biomarkers, NT-pro-BNP and cystatin C, are increased in comparison to normal pregnancy.
Rafik Hamad
Rangeen
R
Department of Woman and Child Health, Division of Obstetrics and Gynaecology, Karolinska Institutet, Stockholm, Sweden. rangeen.rafik-hamad@karolinska.se
Larsson
Anders
A
Pernow
John
J
Bremme
Katarina
K
Eriksson
Maria J
MJ
D000328:Adult; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D055316:Cystatin C / Q000097:blood; D004452:Echocardiography; D005260:Female; D005919:Glomerular Filtration Rate; D006352:Heart Ventricles / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011225:Pre-Eclampsia / Q000503:physiopathology*; D011247:Pregnancy; D019210:Troponin I / Q000097:blood
D015415:Biomarkers; D055316:Cystatin C; D010446:Peptide Fragments; D019210:Troponin I; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein