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Long-Term Postpartum Cardiac Function and Its Association With Preeclampsia.

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|February 23, 2021
PubMed
Summary

Preeclampsia is linked to long-term heart issues. This study found elevated activin A levels and impaired cardiac function, specifically reduced global longitudinal strain, persist 10 years after preeclampsia.

Keywords:
cardiac dysfunctionglobal longitudinal strainhypertensionpreeclampsia/pregnancypregnancy and postpartum

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Area of Science:

  • Cardiovascular Disease Research
  • Reproductive Health Science
  • Endocrinology

Background:

  • Preeclampsia significantly increases long-term cardiovascular disease risk, including heart failure.
  • Mechanisms linking preeclampsia to cardiac dysfunction are not fully understood.
  • Elevated activin A, a glycoprotein growth factor, is implicated, with previous studies showing associations with impaired cardiac function postpartum.

Purpose of the Study:

  • To investigate if elevated activin A levels and impaired cardiac function persist beyond one year after preeclampsia.
  • To test the hypothesis that activin A levels remain high and correlate with cardiac dysfunction 10 years post-preeclampsia.

Main Methods:

  • Echocardiograms and serum activin A levels were measured in women approximately 10 years after pregnancy.
  • Two groups were studied: those with a history of preeclampsia (n=21) and those with an uncomplicated pregnancy (n=25).
  • Multivariable analysis adjusted for age, blood pressure, race, and BMI.

Main Results:

  • Women with a preeclampsia history showed significantly worse global longitudinal strain, increased left ventricular posterior wall thickness, and interventricular septal thickness compared to controls.
  • Elevated serum activin A levels and an increased activin/follistatin-like 3 ratio were observed in the preeclampsia group.
  • The association between higher activin A levels and reduced global longitudinal strain remained significant after multivariable adjustment.

Conclusions:

  • Preeclampsia is associated with persistent elevations in activin A and impaired cardiac function, specifically reduced global longitudinal strain, up to 10 years postpartum.
  • These findings highlight a potential long-term impact of preeclampsia on cardiac health mediated by activin A.
  • Further research is warranted to elucidate the precise relationship between preeclampsia, activin A, and sustained cardiac dysfunction.