P948 Assessment of maternal cardiac remodeling and systolic function by 3D echocardiography in gestational hypertension and preeclampsia

Abstract

Abstract Background It was recently showed that there is a difference between 3D and 2D evaluation of the left ventricular (LV) myocardial mass and cardiac function in gestational hypertension (GH) probably due to more pronounced heart shape changes in hypertensive pregnant women. It is also known that preeclampsia (PE) is associated with a deterioration in maternal cardiac function. Purpose: We were interested whether there was a difference in 3D morphological and functional parameters of the LV in relation to the blood pressure (BP) profile in GH, but also between GH and PE. Methods: 22 women and 55 with GH (28 with dipping pattern of BP, and 27 non-dippers) underwent 3D echocardiography and ambulatory blood pressure monitoring in the third trimester. LV mass index, LV volumes, SV index and parameters of systolic function of the LV: CO index, EF, longitudinal strain (LS), circumferential strain (CS), radial strain (RS) and area strain (AS) were estimated using 3D software. These three groups (PE, dippers and non-dippers) were each other"s control. Results: Groups did not differ in age and LV massi. SVi was significantly lower in non-dippers (p = 0,045) and PE (p = 0,031) compared with dippers, without significant difference between non-dippers and PE (p = 0,59). Similar results were obtained when we analyzed the EF in these three groups. COi was the lowest in PE (2,76 ± 0,3), compared with dippers (3,43 ± 0,5; p< 0,0005), with significant difference between non-dippers (2,97 ± 0,4; p< 0,0005) and dippers, and with a small difference between PE and non-dippers (p = 0,045). Evaluation of the systolic function by 3D strain, also showed that the systolic function was significantly lower in PE, but also in non-dippers compared to dippers (Table 1). Multivariate regression analysis revealed that nocturnal BP (p = 0,001; OR 1,106; 95% CI 1,029 - 1,142) and presence of proteinuria (p< 0,0005; OR 7,2; 95% CI 1,896 – 36,5) strongly predict preterm delivery. Conclusions: Deterioration of 3D systolic function is more pronaunced in PE, but also in non-dipping pattern of BP in GH compared with dippers, without significant difference in 3D LV massi between groups. Values od 3D strain in groups Dippers Non-dippers PE p1 p2 p3 LS -18,62 -16,99 -16,91 p< 0,0005 p< 0,0005 ns CS -18,22 -16,22 -16,21 p< 0,0005 p< 0,0005 ns RS 52,85 48,3 48,1 p< 0,0005 p< 0,0005 ns AS -31,77 -27,67 -27,98 p< 0,0005 p< 0,0005 ns p1 - difference between dippers and non-dippers; p2 - difference between dippers and PE; p3 - difference between non-dippers and PE