Long-term consequences of previous preeclampsia and complicated pregnancy: analysis of echocardiographic aspects
| Autor: | Claudio Borghi, Federica Fogacci, Arrigo F G Cicero, Stefano Bacchelli, Leonardo Moroni, Giacomo Nicolini, Daniela Degli Esposti, Eugenia Ianniello |
|---|---|
| Přispěvatelé: | Giacomo Nicolini, Daniela Degli Esposti, Eugenia Ianniello, Leonardo Moroni, Stefano Bacchelli, Arrigo Francesco Giuseppe Cicero, Federica Fogacci, Claudio Borghi |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Heart Ventricles Ventricular Dysfunction Right Risk Assessment Preeclampsia Obstetric Labor Premature Pre-Eclampsia Pregnancy Diabetes mellitus Internal medicine Rheumatic Diseases medicine Diabetes Mellitus Humans Reproductive History Subclinical infection Cardiovascular risk echocardiography hypertension long-term consequences preeclampsia pregnancy complications business.industry Infant Newborn Retrospective cohort study General Medicine Odds ratio Middle Aged medicine.disease Prognosis Cross-Sectional Studies Italy Echocardiography Hypertension Infant Small for Gestational Age Cardiology Female Cardiology and Cardiovascular Medicine Complication business Dyslipidemia |
| Zdroj: | Journal of cardiovascular medicine (Hagerstown, Md.). 22(12) |
| ISSN: | 1558-2035 |
| Popis: | Introduction Preeclampsia has an increased risk of cardiovascular events later in life. In this retrospective study, we evaluated echocardiographic aspects in women with history of preeclampsia or preeclampsia-related complications in their previous pregnancies. Materials and methods Consecutive women receiving echocardiography during daily clinical echolab activity were studied using complete echocardiographic examination data and anamnestic data collection of hypertension, diabetes, dyslipidemia, and rheumatic diseases. Studied women should have at least one pregnancy in more than the 10 past years, and were subdivided into two groups according to the history of complicated or physiological pregnancy. Complicated pregnancies were defined by preeclampsia or preeclampsia-related complication, such as preterm delivery or small-for-gestational age newborn. Echocardiographic parameters and prevalence of hypertension, diabetes, dyslipidemia, and rheumatic disease were compared between the two groups of studied women. Results From March 2016 to May 2020, 545 women were studied, of whom 218 had a history of complicated pregnancy (mean age 60.81 ± 11.109 years vs. 62.78 ± 9.758 years of not complicated pregnancy; P = 0.03). Compared with physiological pregnancy women, complicated pregnancy ones were shorter (159.97 ± 6.608 vs. 161.42 ± 6.427 cm; P = 0.012) with lower body surface area (1.678 ± 0.1937 vs. 1.715 ± 0.1662 m2; P = 0.02), had higher prevalence of diabetes (6.9 vs. 3.1%; P = 0.04; odds ratio = 2.34; CI 1.0323--5.3148) and rheumatic diseases (33 vs. 22.3%; P = 0.006; odds ratio = 1.72; CI 1.1688--2.5191), and showed a slight, not significant higher prevalence of hypertension. As for echocardiographic parameters, they showed significantly higher values of end-diastolic left ventricular posterior wall (LPWd) (P = 0.034), a trend toward a more concentric geometry, and a worse longitudinal systolic left and right ventricle performance, represented by lower tissue Doppler systolic waves (septal: 7.41 ± 1.255 vs. 7.69 ± 1.376 cm/s; P = 0.018; and tricuspidalic: 12.64 ± 2.377 vs. 13.32 ± 2.548 cm/s; P = 0.003). Conclusion Patients with previous preeclampsia present an increased risk of hypertension, diabetes, and rheumatic diseases, suggesting that these women could share a specific predisposition to a high-risk profile. Furthermore, they show a higher prevalence of classically considered echocardiographic hypertensive-derived cardiac damage, suggesting structural and functional left ventricular modifications as subclinical aspects of long-term worse cardiovascular prognosis for these women. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|