Study of heart function in PRE-Eclampsia during and after PreGnancy (SHePREG): The pilot cohort

Abstract

BackgroundPre-eclampsia with severe features (severe PreE) is associated with heart dysfunction, yet the impact beyond pregnancy, including its association with cardiomyopathic genetic polymorphisms, remains poorly understood. ObjectiveWe aimed to characterize the temporal impact of severe PreE on heart function through the 4th trimester in women with and without deleterious cardiomyopathic genetic variants. MethodsPregnant women were enrolled to undergo transthoracic echocardiography (TTE) in late pregnancy and 3 months postpartum. In women with severe PreE a targeted approach to identify pathogenic cardiomyopathic genetic polymorphisms was undertaken, and heart function was compared in carriers and non-carriers. ResultsPregnant women (32 ± 4 years old, severe PreE = 14, control = 8) were enrolled between 2019 - 2021. Women with severe PreE displayed attenuated myocardial relaxation (mitral e’ = 11.0 ± 2.2 vs. 13.2 ± 2.3 cm/sec, p < 0.05) in late pregnancy, and on in-silico analysis, deleterious cardiomyopathic variants were found in 58%. At 103 ± 33 days postpartum, control women showed stability in myocardial relaxation (Mitral e’ Entry: 13.2 ± 2.3 vs. Postpartum: 13.9 ± 1.7cm/sec, p = 0.464), and genetic negative severe PreE women (G-) demonstrated recovery of diastolic function to control level (Mitral e’ Entry: 11.0 ± 3.0 vs. Postpartum 13.7 ± 2.8cm/sec, p < 0.001), unlike their genetic positive (G+) counterparts (Mitral e’ Entry: 10.5 ± 1.7 vs. Postpartum 10.8 ± 2.4cm/sec, p = 0.853). ConclusionsPostpartum recovery of heart function after severe PreE is attenuated in women with deleterious cardiomyopathic genetic polymorphisms.