Left ventricular function many years after recovery from pre-eclampsia
Article first published online: 18 NOV 2010
© 2010 The Authors Journal compilation © RCOG 2010 BJOG An International Journal of Obstetrics and Gynaecology
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 118, Issue 1, pages 76–83, January 2011
How to Cite
Strobl, I., Windbichler, G., Strasak, A., Weiskopf-Schwendinger, V., Schweigmann, U., Ramoni, A. and Scheier, M. (2011), Left ventricular function many years after recovery from pre-eclampsia. BJOG: An International Journal of Obstetrics & Gynaecology, 118: 76–83. doi: 10.1111/j.1471-0528.2010.02780.x
- Issue published online: 10 DEC 2010
- Article first published online: 18 NOV 2010
- Accepted 6 October 2010. Published Online 18 November 2010.
- Cardiac function;
- maternal haemodynamics;
Please cite this paper as: Strobl I, Windbichler G, Strasak A, Weiskopf-Schwendinger V, Schweigmann U, Ramoni A, Scheier M. Left ventricular function many years after recovery from pre-eclampsia. BJOG 2011;118:76–83.
Objective Epidemiological observations have shown that women with pre-eclampsia are at increased risk for subsequent development of cardiovascular disease. We evaluated maternal haemodynamics in asymptomatic women many years after pre-eclampsia and HELLP (haemolysis, elevated liver enzymes and low platelets) syndrome.
Design Case–control study.
Setting University-based department of obstetrics.
Population Forty-eight women, 13–18 years after the affected pregnancy: 17 women with a history of HELLP syndrome, 14 women with a history of pre-eclampsia and 17 women following normal pregnancy (control group).
Methods Echocardiographic examination was performed in all groups, recording the isovolumetric contraction time and isovolumetric relaxation time (ICT + IVRT), ejection time (ET), myocardial performance index (MPI), transmitral early to atrial filling velocity ratio (MV-E/MV-A), stroke volume (SV) and cardiac output (CO).
Main outcome measures Cardiac function.
Results Women with previous HELLP syndrome showed a significantly increased MPI (0.34 versus 0.26; P = 0.008) and ICT + IVRT (442.16 versus 415.03; P = 0.01); MV-E/A, SV, ET and CO were not significantly different. Women with a history of pre-eclampsia showed a significantly increased MPI (0.36 versus 0.26; P = 0.006) and decreased ET (317.3 versus 328.93; P = 0.04); ICT + IVRT, MV-E/A, SV and CO were not significantly different.
Conclusion This study confirms epidemiological observations that women with pre-eclampsia are at increased risk for subsequent development of cardiovascular disease. Many years after HELLP syndrome or pre-eclampsia, asymptomatic women have an increased risk for impaired cardiac function as shown by an increased MPI.