title: Maternal cardiac dysfunction and remodeling in women with preeclampsia at term.
abstract: Preeclampsia is a disease associated with significant cardiovascular morbidity during pregnancy and in later life. This study was designed to evaluate cardiac function and remodeling in preeclampsia occurring at term. This was a prospective case-control study of 50 term preeclampsia and 50 normal pregnancies assessed by echocardiography and tissue Doppler analysis. Global diastolic dysfunction was observed more frequently in preeclampsia versus control pregnancies (40% versus 14%, P = 0.007). Increased cardiac work and left ventricular mass indices suggest that left ventricular remodeling was an adaptive response to maintain myocardial contractility with preeclampsia at term. Approximately 20% of patients with preeclampsia at term have more evident myocardial damage. Diastolic dysfunction usually precedes systolic dysfunction in the evolution of ischemic or hypertensive cardiac diseases and is of prognostic value in the prediction of long-term cardiovascular morbidity. The study findings also have significant implications for the acute medical management of preeclampsia.
authors.affiliation: Department of Obstetrics and Gynecology, St Georges Hospital, University of London, London, UK.
authors.forename: Karen
authors.initials: K
authors.lastname: Melchiorre
authors.forename: George Ross
authors.initials: GR
authors.lastname: Sutherland
authors.forename: Aigul
authors.initials: A
authors.lastname: Baltabaeva
authors.forename: Marco
authors.initials: M
authors.lastname: Liberati
authors.forename: Basky
authors.initials: B
authors.lastname: Thilaganathan
mesh_terms: D000328:Adult; D002302:Cardiac Output; D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D016022:Case-Control Studies; D015150:Echocardiography, Doppler; D005260:Female; D006321:Heart / Q000503:physiopathology; D006801:Humans; D009200:Myocardial Contraction; D011225:Pre-Eclampsia / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011247:Pregnancy; D011446:Prospective Studies; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology; D020257:Ventricular Remodeling