Cardiovascular effects of severe late-onset preeclampsia are reversed within six months postpartum
(2020) In Pregnancy Hypertension 19. p.18-24- Abstract
OBJECTIVES: Preeclampsia (PE) is a common pregnancy-related disorder associated with cardiovascular long-term disease. Eighty percent are late-onset PE, occurring after 34 gestational weeks, and can present with severe symptoms. Magnitude and reversibility rate of maternal cardiovascular changes after severe late-onset PE have not been characterized. This study therefore evaluated longitudinal dynamics of maternal cardiovascular changes after severe late-onset PE.
STUDY DESIGN: Six previously normotensive women with severe late-onset PE and eight pregnant controls were included. Severe PE was defined as systolic blood pressure (SBP) ≥ 160 mmHg or diastolic blood pressure (DBP) ≥ 110 mmHg and proteinuria with/without evidence of... (More)
OBJECTIVES: Preeclampsia (PE) is a common pregnancy-related disorder associated with cardiovascular long-term disease. Eighty percent are late-onset PE, occurring after 34 gestational weeks, and can present with severe symptoms. Magnitude and reversibility rate of maternal cardiovascular changes after severe late-onset PE have not been characterized. This study therefore evaluated longitudinal dynamics of maternal cardiovascular changes after severe late-onset PE.
STUDY DESIGN: Six previously normotensive women with severe late-onset PE and eight pregnant controls were included. Severe PE was defined as systolic blood pressure (SBP) ≥ 160 mmHg or diastolic blood pressure (DBP) ≥ 110 mmHg and proteinuria with/without evidence of end-organ dysfunction, or SBP ≥ 140 mmHg or DBP ≥ 90 mmHg with/without proteinuria and with evidence of end-organ dysfunction. Cardiovascular function was assessed by magnetic resonance imaging at 1-3 days, one week and six months postpartum.
RESULTS: Left ventricular mass at 1-3 days postpartum was higher after severe late-onset PE (57 g/m2) compared to after normal pregnancy (48 g/m2; p = 0.01). Pulse wave velocity (PWV) decreased between 1 and 3 days and six months postpartum after PE (6.1 to 5.0 m/s; p = 0.028). There was no difference in PWV 1-3 days postpartum after severe PE compared after normal pregnancy (6.1 versus 5.6 m/s; p = 0.175). Blood pressure normalized within six months in all but one patient.
CONCLUSIONS: Cardiac effects after severe late-onset PE were small and transient. This indicates that left ventricular hypertrophy after severe late-onset PE may be a secondary physiologic response to increased peripheral resistance in PE. Vascular mechanisms rather than persistent cardiac hypertrophy postpartum may be the culprit for increased long-term cardiovascular risk after PE.
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- author
- Kalapotharakos, Grigorios LU ; Salehi, Daniel LU ; Steding-Ehrenborg, Katarina LU ; Andersson, Maria LU ; Arheden, Håkan LU ; Hansson, Stefan R LU and Hedström, Erik LU
- organization
- publishing date
- 2020
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Pregnancy Hypertension
- volume
- 19
- pages
- 18 - 24
- publisher
- Elsevier
- external identifiers
-
- pmid:31864208
- scopus:85076757226
- ISSN
- 2210-7797
- DOI
- 10.1016/j.preghy.2019.12.005
- project
- Fetal and maternal cardiovascular physiology in complicated pregnancy
- language
- English
- LU publication?
- yes
- additional info
- Copyright © 2019 The Author(s). Published by Elsevier B.V. All rights reserved.
- id
- 0be65d4c-3e99-41e9-92ee-2af6099cd79d
- date added to LUP
- 2019-12-23 08:23:52
- date last changed
- 2024-08-21 13:15:38
@article{0be65d4c-3e99-41e9-92ee-2af6099cd79d, abstract = {{<p>OBJECTIVES: Preeclampsia (PE) is a common pregnancy-related disorder associated with cardiovascular long-term disease. Eighty percent are late-onset PE, occurring after 34 gestational weeks, and can present with severe symptoms. Magnitude and reversibility rate of maternal cardiovascular changes after severe late-onset PE have not been characterized. This study therefore evaluated longitudinal dynamics of maternal cardiovascular changes after severe late-onset PE.</p><p>STUDY DESIGN: Six previously normotensive women with severe late-onset PE and eight pregnant controls were included. Severe PE was defined as systolic blood pressure (SBP) ≥ 160 mmHg or diastolic blood pressure (DBP) ≥ 110 mmHg and proteinuria with/without evidence of end-organ dysfunction, or SBP ≥ 140 mmHg or DBP ≥ 90 mmHg with/without proteinuria and with evidence of end-organ dysfunction. Cardiovascular function was assessed by magnetic resonance imaging at 1-3 days, one week and six months postpartum.</p><p>RESULTS: Left ventricular mass at 1-3 days postpartum was higher after severe late-onset PE (57 g/m2) compared to after normal pregnancy (48 g/m2; p = 0.01). Pulse wave velocity (PWV) decreased between 1 and 3 days and six months postpartum after PE (6.1 to 5.0 m/s; p = 0.028). There was no difference in PWV 1-3 days postpartum after severe PE compared after normal pregnancy (6.1 versus 5.6 m/s; p = 0.175). Blood pressure normalized within six months in all but one patient.</p><p>CONCLUSIONS: Cardiac effects after severe late-onset PE were small and transient. This indicates that left ventricular hypertrophy after severe late-onset PE may be a secondary physiologic response to increased peripheral resistance in PE. Vascular mechanisms rather than persistent cardiac hypertrophy postpartum may be the culprit for increased long-term cardiovascular risk after PE.</p>}}, author = {{Kalapotharakos, Grigorios and Salehi, Daniel and Steding-Ehrenborg, Katarina and Andersson, Maria and Arheden, Håkan and Hansson, Stefan R and Hedström, Erik}}, issn = {{2210-7797}}, language = {{eng}}, pages = {{18--24}}, publisher = {{Elsevier}}, series = {{Pregnancy Hypertension}}, title = {{Cardiovascular effects of severe late-onset preeclampsia are reversed within six months postpartum}}, url = {{http://dx.doi.org/10.1016/j.preghy.2019.12.005}}, doi = {{10.1016/j.preghy.2019.12.005}}, volume = {{19}}, year = {{2020}}, }