title: Detection of early left ventricular dysfunction in patients with maternal placental syndrome using tissue Doppler and strain rate imaging.
abstract: BACKGROUND
  Maternal placental syndromes (MPS) occur as a consequence of abnormal placental vessel formation and refer to hypertensive pregnancy disorders and related placental abnormalities. The aim of this study is to investigate early alterations in left ventricular function in patients with history of MPS using tissue Doppler and strain rate imaging.
  
  
  METHODS
  We enrolled 122 females who were 6 months after delivery. Group 1 included 72 patients who experienced MPS. Group 2 included 50 women with normal pregnancy as control.
  
  
  RESULTS
  There was no significant difference between both groups with regard to ejection fraction, deceleration time, isovolumetric relaxation time, or E/A ratio. Deterioration of left ventricular systolic and diastolic function was evident in the MPS group, by TDI parameters (significantly lower values of Sm 7.5 ± 1.2 vs. 9.1 ± 1.3, p < 0.001; Em 7.0 ± 0.8 vs. 10.0 ± 1.4, p = 0.02; and Em-to-Am ratio 0.84 ± 0.14 vs. 1.2 ± 0.18, p < 0.001). Systolic strain, peak systolic strain rate, and early and late diastolic strain rates were also significantly lower in patients who had MPS than in the control group (-18.7 ± 2.6 vs. -20.8 ± 1.5, p < 0.001; -0.92 ± 0.14 vs. -1.01 ± 0.23, p < 0.001; 1.05 ± 0.11 vs. 1.29 ± 0.24, p < 0.001; 1.8 ± 0.3 vs. 1.2 ± 0.4, p < 0.001, respectively) and in patients who had severe pre-eclampia than mild pre-eclampsia. Pre-eclamptic women who had preterm delivery showed significantly higher left diastolic dysfunction.
  
  
  CONCLUSIONS
  Left ventricular systolic and diastolic dysfunction occur in patients with history of MPS. These abnormalities are evident on tissue Doppler and strain imaging even in the absence of changes in ejection fraction or standard diastolic parameters.
authors: Department of Obstetric and Gynecology and.
authors: Walid
authors: W
authors: Attalla
authors: Rania
authors: R
authors: Gaber
authors: Suzan
authors: S
authors: Bayomy
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D010922:Placenta Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011247:Pregnancy; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*; D055815:Young Adult
keywords: Maternal morbidity and mortality; pre-eclampsia