Low Plasma Volume and Increased Pressure Load Relate to Concentric Left Ventricular Remodeling After Preeclampsia: A Longitudinal Study

Autor: Robert-Jan Alers, Marc E. A. Spaanderman, Sander M. J. van Kuijk, Ralph R. Scholten, Wieteke M. Heidema, Jolijn van Neer, Maureen J. van der Vlugt, Arie P.J. van Dijk, Nicolette M. Breetveld, Hans-Peter Brunner-La Rocca, Chahinda Ghossein-Doha, Lauren Geerts, Vanessa P. M. van Empel
Přispěvatelé: Obstetrie & Gynaecologie, MUMC+: MA Arts Assistenten Obstetrie Gynaecologie (9), RS: GROW - R4 - Reproductive and Perinatal Medicine, MUMC+: KIO Kemta (9), Epidemiologie, RS: CAPHRI - R2 - Creating Value-Based Health Care, MUMC+: MA Medische Staf Obstetrie Gynaecologie (9), Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9), RS: Carim - H02 Cardiomyopathy, MUMC+: MA Med Staf Artsass Interne Geneeskunde (9)
Rok vydání: 2020
Předmět:
Adult
medicine.medical_specialty
Longitudinal study
Vascular damage Radboud Institute for Health Sciences [Radboudumc 16]
030204 cardiovascular system & hematology
Concentric
RECOMMENDATIONS
DISEASE
Preeclampsia
preeclampsia
03 medical and health sciences
All institutes and research themes of the Radboud University Medical Center
0302 clinical medicine
Pre-Eclampsia
Pregnancy
Internal medicine
medicine
Humans
echocardiography
Eccentric
Longitudinal Studies
Ventricular remodeling
Original Research
plasma volume
Heart Failure
030219 obstetrics & reproductive medicine
Ventricular Remodeling
business.industry
blood pressure
medicine.disease
Remodeling
concentric remodeling
medicine.anatomical_structure
Blood pressure
Ventricle
Hypertension
Cardiology
Gestation
Female
Cardiology and Cardiovascular Medicine
business
Zdroj: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, 9
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, 9, 19
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Journal of the American Heart Association, 9(19):015043. Wiley
ISSN: 2047-9980
Popis: Background During uncomplicated pregnancy, left ventricular remodeling occurs in an eccentric way. In contrast, during preeclamptic gestation, the left ventricle hypertrophies concentrically, concurrent with loss in circulatory volume and increased blood pressure. Concentric cardiac structure persists in a substantial proportion of women and may be associated with pressure and volume load after preeclampsia. We hypothesize that low volume load, as indicated by plasma volume (PV) after preeclampsia and increased pressure load, is associated with remote concentric remodeling. Methods and Results In this longitudinal cohort study, we included 100 formerly preeclamptic women. Two visits were performed: at 0.8 years postpartum and at 4.8 years postpartum. During visit 1, we measured blood pressure and PV (I 125 dilution technique, low PV ≤48 mL/kg lean body mass). During the second visit, we assessed cardiac geometry by cardiac ultrasound. Concentric remodeling was defined as relative wall thickness >0.42 and left ventricular mass index ≤95 g/m 2 . We adjusted multivariable analysis for primiparity, systolic blood pressure, PV mL/kg lean body mass, and antihypertensive medication at visit 1. Low PV is associated with remote concentric remodeling (odds ratio [OR], 4.37; 95% CI, 1.06–17.40; and adjusted OR, 4.67; 95% CI, 1.02–21.42). Arterial pressure load (systolic, diastolic, and mean arterial pressure) is also associated with development of concentric remodeling (OR, 1.15 [95% CI, 0.99–1.35]; OR, 1.24 [95% CI, 0.98–1.58]; and OR, 1.20 [95% CI, 0.98–1.47], respectively). Conclusions In former preeclamptic women, development toward left ventricular concentric remodeling is associated with low volume load and increased pressure load.
Databáze: OpenAIRE
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