Prevalence of asymptomatic heart failure in formerly pre-eclamptic women: a cohort study
| Autor: | N. M. Breetveld, S. M. J. van Kuijk, Ralph R. Scholten, Vanessa P. M. van Empel, M. J. van der Vlugt, Wieteke M. Heidema, J. van Neer, H. P. Brunner-La Rocca, A.P.J. van Dijk, Chahinda Ghossein-Doha, Marc E. A. Spaanderman |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Heart disease Diastole 030204 cardiovascular system & hematology Left ventricular hypertrophy Asymptomatic 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Radiology Nuclear Medicine and imaging Pregnancy 030219 obstetrics & reproductive medicine Ejection fraction Radiological and Ultrasound Technology business.industry Obstetrics Obstetrics and Gynecology General Medicine medicine.disease Reproductive Medicine Heart failure Cardiology medicine.symptom business Cohort study |
| Zdroj: | Ultrasound in Obstetrics & Gynecology. 49:134-142 |
| ISSN: | 0960-7692 |
| DOI: | 10.1002/uog.16014 |
| Popis: | Objectives After pre-eclampsia (PE), the prevalence of structural heart disease without symptoms, i.e. heart failure Stage B (HF-B), may be as high as one in four women in the first year postpartum. We hypothesize that a significant number of formerly pre-eclamptic women with HF-B postpartum are still in their resolving period and will not have HF-B during follow-up. Methods In this prospective longitudinal cohort study, we included 69 formerly pre-eclamptic women who underwent serial echocardiographic measurements at 1 and 4 years postpartum. HF-B was diagnosed as left ventricular hypertrophy (left ventricular mass index (LVMi) > 95 g/m2), concentric remodeling (relative wall thickness > 0.42 and LVMi ≤ 95 g/m2), mild systolic dysfunction (left ventricular ejection fraction > 40% and < 55%) or asymptomatic valvular disease. Women were subdivided and analyzed according to HF-B outcome: no HF-B at either visit; HF-B at first visit only; HF-B at second visit only; HF-B at both visits. Results The prevalence of HF-B in formerly pre-eclamptic women was 23% in the first year postpartum and 23% after 4 years. At the second visit, HF-B had resolved in 62.5% of affected women but was newly developed in 19% of initially unaffected women. At the first visit, 56% of women diagnosed with HF-B had reduced systolic function whereas at the second visit 69% of women with HF-B had concentric remodeling with mostly normal ejection fraction, consistent with diastolic dysfunction. Conclusions The prevalence of HF-B can be considered consistently high (1 in 4) amongst formerly pre-eclamptic women at follow-up. Nonetheless, at an individual level, more than 60% of women found initially to be affected by HF-B will recover, whilst about 20% of formerly pre-eclamptic women with normal echocardiography in the first year postpartum will develop HF-B over the following years. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. |
| Databáze: | OpenAIRE |
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