Assessment of RV Systolic Function by Two-Dimensional Speckle Tracking Echocardiography in Patients with Preeclampsia before and after Labor

Abstract

Background: preeclampsia (PE) is one of the most common causes of maternal mortality and morbidity worldwide. Although cardiovascular (CV) risk is increased after PE, a direct causative relationship has not yet been determined. Aim of the Work: to evaluate and detect subclinical RV dysfunction by 2D speckle tracking echocardiography in preeclamptic patients before and after labor. Patients and Methods: 60 pregnant women were selected for this sectional comparative study which was conducted at Cardiology Department, Faculty of Medicine, Al-Azhar University during the period from October 2018 to June 2019. Results: comparison between before labor and 6 weeks after labor of the right ventricle of the preeclamptic patients showed that tricuspid annular plane systolic excursion (TAPSE) was 22.33 ±3.08 and 26.48 ±2.20, respectively with change of 4.15 (18.6%), with a statistically highly significant difference (p <0.001), end-systolic pulmonary arterial pressure (ESPAP) was 14.65 ±1.63 mmHg and 8.35 ±1.76 mmHg, respectively with change of -6.3 (43%), it showed a statistically highly significant difference (p <0.001), fractional area change (FAC) was 50.55 ±2.25 and 53.40 ±1.66, respectively with change of 2.85 (5.6%), it showed a statistically highly significant difference (p <0.001), right ventricular index of myocardial performance (RIMP) was 41.45 ±2.11 and 33.28 ±2.34, respectively with change of -8.17 (19.7%). Conclusions: two-dimensional speckle echocardiography proved to be acceptable, and applicable for assessing rightsided heart function in patients with preeclampsia. Using this image modality demonstrated significant differences in right ventricular measurements to overcome further morbidity and mortality of those patients