Maternal left ventricular and endothelial functions in preeclampsia

Abstract

Objective: To compare maternal left ventricular and endothelial functions in preeclampsia and normal pregnancy, during pregnancy and after delivery.

Design: Observational study with follow-up.

Setting: University hospital and midwife-led antenatal care center.

Samples: Twenty untreated women with preeclampsia and 20 women with normal pregnancy, matched for gestational age and parity.

Methods: The women were examined during pregnancy and three months after delivery. Left ventricular function was assessed by echocardiography, including tissue-Doppler imaging. Endothelial function was assessed by measuring flow-mediated dilation of the brachial artery.

Main outcome measures: Early diastolic mitral annular tissue velocity, "e", peak systolic tissue velocity, "S", and flow-mediated dilation.

Results: The diastolic function was reduced in preeclampsia, with lower "e", and there was a higher ratio of early diastolic mitral inflow velocity and early diastolic mitral annular velocity, "E/e". Early diastolic mitral inflow deceleration time and isovolumetric relaxation time were similar between the groups, suggesting pseudonormalization and increased filling pressures in preeclampsia. "S" was lower in the preeclampsia group during pregnancy. Both diastolic and systolic left ventricular functions normalized postpartum. The flow-mediated dilation was impaired in the preeclampsia group both during pregnancy and three months after delivery.

Conclusions: The maternal left ventricular function was impaired during preeclampsia but had normalized three months after delivery. The endothelial function, measured by flow-mediated dilation, was impaired in the preeclampsia group as compared with the normal pregnancy group both during pregnancy and three months after delivery.

© 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.