title: Is preeclampsia an independent predictor of diastolic dysfunction? A retrospective cohort study.
abstract: OBJECTIVE
  To determine if preeclampsia is an independent predictor of diastolic dysfunction and what factors among patients with preeclampsia are associated with diastolic dysfunction.
  
  
  METHODS
  This is a retrospective cohort study of patients who delivered between 2008 and 2013 at a single institution who had a maternal echocardiogram during their pregnancy or within 5months of delivery. Patients with structural heart disease, ejection fraction less than 45%, pulmonary embolus, or age over 45years were excluded. Medical records were reviewed for medical and obstetric complications and echocardiogram findings. Demographic characteristics and rate of diastolic dysfunction were compared between patients with preeclampsia and without preeclampsia. Multivariate logistic regression was performed controlling for age, ethnicity, gestational age at delivery, diabetes, preeclampsia, intrauterine growth restriction (IUGR), antihypertensive use and magnesium sulfate administration.
  
  
  RESULTS
  Sixty-six patients were identified, of which 39 (59%) had preeclampsia. Past history of preeclampsia, IUGR in the current pregnancy, antihypertensive use and magnesium sulfate use were higher in the preeclampsia group. Fifteen patients (39%) in the preeclampsia group were African-American compared to 2 (3%) in the control group (p<0.01). Seventeen (44%) of the patients with preeclampsia were found to have diastolic dysfunction compared to 3 (11%) controls (OR=6.18, 95% CI 1.59,24.02; p=0.006). Logistic regression analysis did not reveal other independent predictors of diastolic dysfunction. In the patients with preeclampsia, history of preeclampsia with severe features and IUGR were not associated with diastolic dysfunction.
  
  
  CONCLUSIONS
  Our study supports previous findings that preeclampsia is associated with diastolic dysfunction.
authors.affiliation: Division of Maternal Fetal Medicine, Rutgers New Jersey Medical School, Newark, NJ, United States. Electronic address: guirgugf@njms.rutgers.edu.
authors.forename: George F
authors.initials: GF
authors.lastname: Guirguis
authors.affiliation: Department of Obstetrics, Gynecology, and Women's Health, Atlantic Health System, Morristown, NJ, United States.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Aziz
authors.affiliation: Department of Cardiology, Atlantic Health System, Morristown, NJ, United States.
authors.forename: Claire
authors.initials: C
authors.lastname: Boccia Liang
authors.affiliation: Division of Maternal Fetal Medicine, Rutgers New Jersey Medical School, Newark, NJ, United States.
authors.forename: Shauna F
authors.initials: SF
authors.lastname: Williams
authors.affiliation: Division of Maternal Fetal Medicine, Rutgers New Jersey Medical School, Newark, NJ, United States.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Apuzzio
authors.affiliation: Division of Maternal Fetal Medicine, Rutgers New Jersey Medical School, Newark, NJ, United States.
authors.forename: Robyn
authors.initials: R
authors.lastname: Bilinski
authors.affiliation: Department of Obstetrics, Gynecology, and Women's Health, Atlantic Health System, Morristown, NJ, United States.
authors.forename: Adenieki J D
authors.initials: AJ
authors.lastname: Mornan
authors.affiliation: Department of Maternal Fetal Medicine, Atlantic Health System, Morristown, NJ, United States.
authors.forename: Leena P
authors.initials: LP
authors.lastname: Shah
mesh_terms: D000328:Adult; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging; D006801:Humans; D011225:Pre-Eclampsia / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
keywords: Diastolic myocardial dysfunction; Echocardiography; Preeclampsia