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Updated: May 15, 2025

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Cardiac Structure, Function and Mechanics in Hypertensive Disorders of Pregnancy: A Systematic Review and

Jamie J Edwards1,2, Veronica Giorgione3,4, Megan Griffiths5

  • 1Department of Cardiology, St George's University Hospitals NHS Foundation Trust, London, United Kingdom (J.J.E., E.G., E.S., E.C., A.M., R.S., J.M.O.D.).

Hypertension (Dallas, Tex. : 1979)
|May 14, 2025
PubMed

Insights

Hypertensive disorders of pregnancy (HDP) significantly impair myocardial mechanics and alter cardiac structure compared to healthy pregnancies. Advanced echocardiography can detect these changes for better risk stratification and management of HDP.

Area of Science:

  • Cardiology
  • Obstetrics
  • Medical Imaging

Background:

  • Hypertensive disorders of pregnancy (HDP) are a major cause of maternal morbidity and mortality globally.
  • Early detection and management of HDP are crucial for improving maternal outcomes.

Purpose of the Study:

  • To conduct the largest meta-analysis comparing echocardiographic features in HDP versus healthy pregnancies.
  • To identify key echocardiographic markers for risk stratification in HDP.

Main Methods:

  • Systematic literature search of PubMed and EMBASE up to March 2024.
  • Inclusion of 53 studies with 7168 participants (3381 HDP, 3787 controls).
  • Meta-analysis of conventional and advanced echocardiographic parameters.

Main Results:

  • Impaired myocardial mechanics in HDP, evidenced by reduced global longitudinal strain and left atrial reservoir strain.
  • Significant cardiac structural differences in HDP, including increased left ventricular mass index and left atrial size.
  • Elevated left ventricular filling pressures indicated by a higher ratio of early mitral inflow velocity to early mitral annular velocity.

Conclusions:

  • Clinically significant echocardiographic differences exist between HDP and healthy pregnancies.
  • Advanced echocardiography, particularly myocardial mechanics, aids in detecting subclinical dysfunction in HDP.
  • Echocardiography can enhance risk stratification and guide early intervention for women with HDP.
Abstract

Keywords:
echocardiographyhumanshypertension, pregnacy-inducedpregnancyrisk assessment

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