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Left ventricular function impairment in pregnancy-induced hypertension
M Vázquez Blanco1, J Roisinblit, O Grosso
1Division of Cardiology, Hospital de Clínicas José de San Martín, University of Buenos Aires, Cordoba, Argentina. bvazquez@intramed.net.ar
American Journal of Hypertension
|April 3, 2001
Summary
Pregnancy-induced hypertension can cause left ventricular dysfunction, primarily diastolic dysfunction, after delivery. Echocardiography Doppler, specifically isovolumetric relaxation time (IRT) and Tei index, effectively detects this cardiac impairment.
Area of Science:
- Cardiology
- Obstetrics
- Physiology
Background:
- Transient hypertension's effects on cardiac function remain unclear.
- Pregnancy-induced hypertension (PIH) serves as a natural model for studying transient hypertension.
- Echocardiographic Doppler's utility in detecting subclinical cardiac dysfunction needs further assessment.
Purpose of the Study:
- To evaluate left ventricular (LV) function in women with PIH postpartum using echocardiographic Doppler.
- To identify specific echocardiographic parameters indicative of LV dysfunction in PIH.
- To compare cardiac function between women with PIH and normal pregnant women.
Main Methods:
- Studied 28 women with PIH and 20 healthy pregnant women postpartum.
- Utilized echocardiographic Doppler to measure LV diastolic diameter, fractional shortening, E velocity, A velocity, E/A ratio, isovolumetric relaxation time (IRT), isovolumetric contraction time (ICT), ejection time (ET), and Tei index.
- Analyzed data 2-4 days postpartum.
Main Results:
- Women with PIH showed significantly lower E/A ratio (1.3 vs. 1.5, P < .05).
- Significantly prolonged isovolumetric relaxation time (IRT) was observed in the PIH group (104 ms vs. 84 ms, P < .000).
- The Tei index was significantly higher in women with PIH (0.51 vs. 0.35, P < .00), indicating impaired LV function.
Conclusions:
- Pregnancy-induced hypertension is associated with left ventricular dysfunction, predominantly diastolic, detected postpartum.
- Isovolumetric relaxation time (IRT) and the Tei index are sensitive echocardiographic markers for identifying LV dysfunction in PIH.
- Echocardiographic Doppler is a valuable tool for assessing cardiac function in hypertensive disorders of pregnancy.