P101. Cardiac function and ventriculo-arterial interaction 11years after preeclampsia complicated pregnancy

Abstract

Introduction Preeclampsia (PE) is associated with left ventricular systolic and diastolic dysfunction.Studies demonstrated a relationship between PE and cardio-vascular disease (CVD) later in life, however there is little evidence of disturbances in cardiac function at long-term follow-up after PE. Objective The aim of this study was to assess cardiac function and ventriculo-aterial coupling (VAC) in middle-aged women more than 10 years after a pregnancy complicated by PE. Material and Methods Cardiac function in 15 women with history of PE (mean age 39 ± 4 years) and 16 matched healthy controls (41 ± 3 years) was evaluated 11 years following the index pregnancy.Medical and family history was assessed, echocardiography including Tissue Doppler Imaging (DTI) and two-dimensional speckle-tracking echocardiography (2D STE) for myocardial strain imaging were performed.Systolic and diastolic function, left and right ventricular (LV and RV) size and function, LV global strain, LV wall thickness and atrial size as well as stroke volume (SV) and cardiac output (CO), indices of VAC and levels of NT-pro- BNP were analyzed.24-h ambulatory blood pressure measurement was performed.Indices of VAC were measured as effective arterial elastance(EA), EA = LV end-systolic pressure (LVESP)/SV; LV end systolic elastance (ELV), LV = LVESP/LVESV(LV end – ystolic volume), VAC = ratio EA/ELV; Compliance = SV/(SBP − DBP) and total peripheral resistance (TPR) = [DBP + (SBP − DBP)/3]/CO. Results We could not show any significant difference in systolic (111 ± 11 vs 117 ± 14 mmHg) or in diastolic blood pressure (70 ± 2 vs 75 ± 2 mmHg, P = 0.16) between the groups at 11 year follow-up.However there was a significant difference in the night/day SBP and DBP ratios (0.81 ± 0.06 vs 0.76 ± 0.05, and 0.88 ± 0.04 vs 0.84 ± 0.04; both p Conclusion We could not demonstrate alterations in systolic or diastolic left or right ventricular function, or in ventriculo-arterial interaction in women 11 years after a pregnancy complicated by PE, despite sensitive echocardiographic techniques. Pre-existing risk factors may be more important for future cardiovascular complications than myocardial and vascular damage apparent during pregnancy in women with PE.