Impact of gestational hypertension on left ventricular function and geometric pattern

Area of Science:

• Cardiovascular Physiology
• Reproductive Medicine
• Clinical Cardiology

Background:

• The impact of gestational hypertension on cardiac function in young, previously normotensive women remains understudied.
• Gestational hypertensive women (GHW) and normotensive pregnant women (NPW) were compared.

Purpose of the Study:

• To evaluate the effects of gestational hypertension on left ventricular (LV) function in young women.
• To assess cardiac morphology and performance in GHW compared to NPW.

Main Methods:

• Transthoracic echocardiography, including 2D strain imaging, was performed on 106 GHW and 93 NPW.
• Analysis included myocardial performance (Tei index), LV mass index (LVMI), relative wall thickness (RWT), and global longitudinal LV strain.

Main Results:

• GHW exhibited significantly increased LVMI, wall thickness, and RWT compared to NPW.
• Diastolic dysfunction was indicated by longer isovolumetric relaxation time and lower E/A ratio in GHW.
• Longitudinal systolic function was reduced in GHW, with a significantly lower global longitudinal LV strain (-17.6% vs. -21.2%).
• Abnormal LV geometry, specifically eccentric hypertrophy, was prevalent in 40% of GHW.

Conclusions:

• Gestational hypertension is associated with aggravated diastolic and longitudinal systolic dysfunction in young women.
• GHW demonstrate increased LVMI and abnormal cardiac geometry (eccentric hypertrophy).
• The potential for reversibility of these cardiac alterations post-delivery requires further investigation.