Time course of changes in maternal left ventricular function during subsequent pregnancy in women with a history of gestational hypertensive disorders

Michinari Hieda, Jeung Ki Yoo, Dan Dan Sun, Yoshiyuki Okada, Rosemary S. Parker, Monique A. Roberts-Reeves, Beverley A Huet, David B Nelson, Benjamin D Levine, Qi Fu

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Women with a history of gestational hypertensive disorders (GHD) are at increased risk for developing perinatal cardiovascular complications (e.g., gestational hypertension, preeclampsia, etc.) in subsequent pregnancies. The underlying mechanisms remain uncertain, but impaired maternal left ventricular function may be one contributing factor for these complications. We evaluated the time course of changes in left ventricular function before, during, and after pregnancy in women with prior GHD. Sixteen women with a history of GHD (the high-risk group) and 25 women without such a history (controls) were enrolled. Resting hemodynamic and echocardiographic measurements were longitudinally performed before pregnancy, during early pregnancy (4–8 wk of gestation), during late pregnancy (32–36 wk of gestation), and postpartum (6–10 wk after delivery). Pregnancy outcomes were obtained after delivery. At prepregnancy, there was no difference in blood pressure and heart rate between the groups. Corrected isovolumic relaxation time was longer, E/e= was larger, and Tei index was greater in the high-risk group than controls. Moreover, the rate of GHD during the study was significantly greater in the high-risk group than controls [odds ratio = 8.94 (95% confidence interval: 1.55–51.5), P = 0.007]. Multiple logistic regression analysis adjusted for age demonstrated that prepregnancy E/e= was an independent predictor for GHD (P = 0.017). Thus, women with a history of GHD have modestly impaired cardiac function prepregnancy compared with controls, which identifies an increased susceptibility to developing cardiovascular complications during a subsequent pregnancy.

Original languageEnglish (US)
Pages (from-to)R587-R594
JournalAmerican Journal of Physiology - Regulatory Integrative and Comparative Physiology
Volume315
Issue number4
DOIs
StatePublished - Oct 1 2018

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Left Ventricular Function
Mothers
Pregnancy
Pregnancy Induced Hypertension
Control Groups
Pregnancy Outcome
Pre-Eclampsia
Postpartum Period
Heart Rate
Logistic Models
Hemodynamics
History
Odds Ratio
Regression Analysis
Confidence Intervals
Blood Pressure

Keywords

  • Gestational hypertension
  • Left ventricular diastolic function
  • Preeclampsia

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)

Cite this

Time course of changes in maternal left ventricular function during subsequent pregnancy in women with a history of gestational hypertensive disorders. / Hieda, Michinari; Yoo, Jeung Ki; Sun, Dan Dan; Okada, Yoshiyuki; Parker, Rosemary S.; Roberts-Reeves, Monique A.; Huet, Beverley A; Nelson, David B; Levine, Benjamin D; Fu, Qi.

In: American Journal of Physiology - Regulatory Integrative and Comparative Physiology, Vol. 315, No. 4, 01.10.2018, p. R587-R594.

Research output: Contribution to journalArticle

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