102 Early evaluation of myocardial dysfunction in women with history of preeclampsia: The role of speckle tracking

Abstract

Introduction PE increases the prevalence of morphologic and functional alterations of the left ventricle. These changes can persist after pregnancy and would increase the risk of patients to develop chronic hypertension. A commonly used tool in prediction of cardiovascular disease is transthoracic echocardiography (TT-EC). Using TT-EC, patients with early asymptomatic ventricular dysfunction can be identified, which is useful because these patients have benefit with pharmacologic therapy despite being asymptomatic. A new technique for TT-EC (Speckle Tracking) has been developed that is more sensitive to evaluate cardiac functional alterations before they become clinically recognizable. There are currently no studies that evaluate heart function at short or long term after birth in patients with history of PE using speckle tracking. Objective To evaluate if the Speckle Tracking technique can identify early asymptomatic ventricular dysfunction in patients with past history of PE. Method A pilot case-control study was performed in Clinica Davila. 14 patients that had their delivery in our institution were recruited. 6 patients diagnosed with severe preeclampsia (sPE), 4 moderate preeclampsia (mPE) and 4 controls. One year after their delivery a Speckle Tracking index (ST index) using transthoracic echocardiography was performed. Results Our analysis show that patients with history of PE decrease the ST index in comparison with women without history of PE but without statistical significance (p = 0.0729). Dividing by severity of PE the data show significantly difference in the ST index of women with mPE (p = 0.0286), but not in woman with sPE (p = 0.3905), in comparison with the controls. Conclusion Women with history of PE and with asymptomatic ventricular dysfunction showed decrease of the ST index. Speckle tracking analysis could be a good technique to identify if women with history of PE can develop cardiac dysfunction.