OC18.06: Maternal cardiac systolic and diastolic function in term pre‐eclampsia

Abstract

long-term cardiovascular morbidity. Diastolic dysfunction usually precedes systolic dysfunction and is of prognostic value in the prediction of longterm cardiovascular morbidity. This study was designed to evaluate cardiac function in severe preterm preeclampsia. Materials: Prospective case-control study of 27 severe preterm PE and 54 normal control pregnancies. Methods: Echocardiography and Tissue Doppler imaging study. Results: Global diastolic dysfunction was observed in a significant number of PE cases versus controls (52% versus 0%, p<0.0001). The pattern of dysfunction was typical of impaired myocardial relaxation. Women with PE had significantly higher cardiac work index (CWI) and LV mass, suggesting that LV remodelling was an adaptive response to maintain myocardial contractility. There was also a high incidence of high amplitude segmental post-systolic shortening in PE compared to controls (30% versus 0%, p<0.0001). Multiple regression analysis demonstrated that diastolic and systolic dysfunction was significantly correlated to the mean arterial pressure at diagnosis of PE. Conclusions: This is the first study to demonstrate overt global diastolic and subtle longitudinal systolic dysfunction in women with preterm PE. This finding has significant clinical implications for peripartum intravascular volume management and for cardiovascular risk stratification in later life.