title: Early-pregnancy changes in cardiac diastolic function in women with recurrent pre-eclampsia and in previously pre-eclamptic women without recurrent disease.
abstract: OBJECTIVE
  To compare early-pregnancy changes in cardiac diastolic function between formerly pre-eclamptic women with (RECUR) and without (NORECUR) recurrent pre-eclampsia.
  
  
  METHODS
  Retrospective observational cohort study.
  
  
  METHODS
  Tertiary referral centre.
  
  
  METHODS
  Pregnant women with a history of early-onset pre-eclampsia (n = 34).
  
  
  METHODS
  The peak mitral filling velocity in early diastole (E) and at atrial contraction (A), and the E/A ratio were assessed before and at 12, 16 and 20 weeks of gestation in the next pregnancy. Differences in early-pregnancy alterations between women with (RECUR) and without (NORECUR) recurrent pre-eclampsia were evaluated by use of mixed design analysis of covariance.
  
  
  METHODS
  Cardiac function and recurrent pre-eclampsia.
  
  
  RESULTS
  In ten women (29%) pre-eclampsia recurred. By 12 weeks of gestation the E/A ratio had increased in the RECUR group, but not in the NORECUR group (P < 0.01). Moreover, from 16 weeks of gestation onwards, the RECUR group had a lower cardiac output and higher systemic vascular resistance as compared with the NORECUR group (P < 0.05).
  
  
  CONCLUSIONS
  Our results suggest that formerly pre-eclamptic women destined to develop recurrent pre-eclampsia differ from their counterparts who do not develop recurrent pre-eclampsia by impaired first-trimester adaptation of cardiac diastolic function.
authors.affiliation: Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands. s.sep@mumc.nl
authors.forename: S J S
authors.initials: SJ
authors.lastname: Sep
authors.forename: M P H
authors.initials: MP
authors.lastname: Schreurs
authors.forename: S C A M
authors.initials: SC
authors.lastname: Bekkers
authors.forename: A J
authors.initials: AJ
authors.lastname: Kruse
authors.forename: L J
authors.initials: LJ
authors.lastname: Smits
authors.forename: L L H
authors.initials: LL
authors.lastname: Peeters
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology; D002303:Cardiac Output, Low / Q000503:physiopathology*; D015331:Cohort Studies; D003971:Diastole / Q000502:physiology*; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D011225:Pre-Eclampsia / Q000453:epidemiology / Q000503:physiopathology*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D012008:Recurrence; D012189:Retrospective Studies; D014655:Vascular Resistance / Q000502:physiology