O110. Maternal left ventricular dysfunction and remodeling in pregnancy complicated with gestational hypertension

Abstract

Introduction During normal pregnancy, stroke volume and heart rate increase and peripherial vascular resistance (PVR) decreases. In pregnancy complicated with gestational hypertension (GH), however PVR increases and produces pressure overload on the left ventricle. Objectives The purpose of our study was to assess the impact of GH on left ventricular performance and structure in previously normotensive heart. Methods 30 pregnant females suffering from pregnancy induced hypertension in the third trimester and 30 normotensive pregnant females were enrolled. Left ventricular function was assessed using 2D echocardiography, Doppler and tissue Doppler technique. Left ventricular mass normalized on body surface (LVMI), relative wall thickness (RWT), and isovolumetric relaxation time (IVRT) was calculated. Parameters of mitral inflow (E/A, DT, E′), TDI (E/E′) and pulmonary vein flow (S/D, AR, ARdur–Adur) was also assessed. Results In GH, IVRT was increased (92+17ms vs 79+13ms), E/A was lower (1.1+0.2 vs 1.6+0.3), E/E' was higher (8.2+3.1 vs 5.3+1.5) and AR was also increased (0.26+0.4m/s vs 0.22+0.2m/s). Women who developed GH had increased RWT (0.39+0.06mm vs 0.32+0.05mm) and LVMI (82+16g/m 2 vs 66+9g/m 2 p Conclusion GH is associated with preserved left ventricular systolic function and subclinical diastolic dysfunction. Women who developed GH had increased left ventricular mass and wall thickness and had higher prevalence of left ventricular concentric remodelling compared with normotensive pregnancies.