Cardiac Dysfunction and Preeclampsia

Abstract

A pregnancy complicated by preeclampsia identifies both a mother and child with an unusual predisposition to develop cardiovascular diseases.1,2 Therefore, characterization of biological pathways common to both preeclampsia and cardiovascular disease may provide novel insights into both conditions.3 One particular area of interest is whether known triggers for preeclampsia, such as hypoxia, inflammation, and angiogenic imbalance, may also trigger the cardiac dysfunction that has been observed in women with preeclampsia.4 Article see p 734 Early in pregnancy, women who subsequently develop preeclampsia display an increased cardiac output compared with women who have a normotensive pregnancy5,6 (Table). As the clinical syndrome of preeclampsia develops the cardiac output significantly drops,5,10,12 a change that coincides with increases in total vascular resistance. Some studies report a reduction in left ventricular ejection fraction, although within normal limits,11 and tissue Doppler imaging has been used to demonstrate reduced cardiac longitudinal systolic function. Diastolic function, assessed by mitral valve inflow and tissue Doppler imaging of the mitral annulus, …