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Updated: Jun 25, 2025

Assessment of Maternal Vascular Remodeling During Pregnancy in the Mouse Uterus
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Association of Hypertensive Disorders of Pregnancy With Coronary Microvascular Dysfunction 8 to 10 Years After

Malamo E Countouris1, Janet M Catov2,3, Jianhui Zhu1

  • 1Division of Cardiology, Department of Medicine, University of Pittsburgh Medical Center, PA (M.E.C., J.Z., X.C., K.L.B., A.C.S., F.S.V.).

Circulation. Cardiovascular Imaging
|May 21, 2024
PubMed

Insights

History of hypertensive disorders of pregnancy (HDP) is linked to coronary microvascular dysfunction a decade later. This dysfunction may contribute to cardiovascular disease, potentially influenced by metabolic factors like obesity and diabetes.

Area of Science:

  • Cardiology
  • Obstetrics
  • Vascular Biology

Background:

  • Hypertensive disorders of pregnancy (HDP) are linked to later cardiac issues.
  • The role of myocardial microvascular disease in HDP-associated cardiac remodeling and cardiovascular disease (CVD) is unclear.
  • Investigating microvascular dysfunction as a potential link between HDP and CVD is crucial.

Purpose of the Study:

  • To determine if HDP history correlates with coronary microvascular dysfunction (CMD) 8-10 years post-delivery.
  • To assess if CMD correlates with left ventricular (LV) remodeling in women with HDP history.
  • To explore the association between CMD, HDP, and cardiometabolic factors.

Main Methods:

  • Utilized myocardial contrast echocardiography to assess coronary flow reserve (CFR) in women post-delivery.
  • Quantified myocardial perfusion at rest and during dobutamine stress.
  • Calculated CFR as the ratio of stress to rest myocardial blood flow.

Main Results:

  • Individuals with CMD (CFR < 2.0) had a higher prevalence of HDP history (46.2% vs. 16.7%).
  • The association between CFR and HDP was attenuated after adjusting for cardiometabolic factors.
  • Exploratory analysis revealed higher CMD in women with both HDP history and LV remodeling (41.7%).

Conclusions:

  • A history of HDP is associated with coronary microvascular dysfunction up to a decade postpartum.
  • Metabolic factors like obesity and diabetes may partly drive this association.
  • Coronary microvascular dysfunction may be a key mechanism contributing to cardiovascular disease risk in women with HDP history.
Abstract

Keywords:
cardiovascular diseasesechocardiographyhypertension, pregnancy inducedmicrovascular circulationpreeclampsiaventricular remodeling

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