Maternal Cardiac Function at Midgestation and Development of Preeclampsia

Area of Science:

• Cardiovascular Physiology
• Obstetrics
• Maternal-Fetal Medicine

Background:

• Preeclampsia (PE) is a significant risk factor for adverse maternal cardiovascular outcomes.
• The precise role of maternal cardiac function in PE pathophysiology requires further elucidation.

Purpose of the Study:

• To compare midgestation cardiac function between women who develop PE and those with uncomplicated pregnancies.
• To determine if routine midgestation cardiac assessment enhances PE screening performance when combined with existing biomarkers.

Main Methods:

• Utilized echocardiography and speckle tracking imaging to assess left ventricular (LV) systolic and diastolic function.
• Measured mean arterial pressure, uterine artery pulsatility index, and serum biomarkers (placental growth factor, soluble fms-like tyrosine kinase-1).

Main Results:

• Women who developed PE exhibited higher peripheral vascular resistance and mildly reduced LV global longitudinal strain, ejection fraction, cardiac output, and left atrial area.
• A weak correlation was observed between maternal cardiovascular indices and placental function biomarkers.
• Cardiac indices did not significantly improve PE screening performance beyond established risk factors and biomarkers.

Conclusions:

• Women developing PE show increased peripheral vascular resistance and mildly reduced LV function indicators preceding clinical diagnosis.
• Routine cardiac assessments at midgestation are not recommended for improving PE screening due to lack of added performance benefit.