Abstract 14817: Early Alterations in Cardiac Strain in Offspring of Hypertensive Pregnancies: An Echocardiography Study of Infants at Birth and 3 Months
Introduction: In utero exposure to preeclampsia is associated with reductions in longitudinal cardiac strain in young adult life, independent of prematurity. It is unclear whether these changes are present from birth or develop in later postnatal life. We investigated cardiac structure and function in a cohort of preterm infants born to hypertensive and normotensive pregnancies.
Methods: 40 preterm born infants, 26 born to hypertensive pregnancies (mean gestational age 33.8 ± 3.3 weeks and mean birth weight 1.90 ± .72 kg) and 14 born to normotensive pregnancies (mean gestational age 33.0 ± 2.5 weeks and mean birth weight 1.89 ± .51 kg , were enrolled in a study of infant cardiovascular phenotype. Left ventricular structure and function was assessed post-natally and at 3 months of age using a Philips ie33 with 12MHz probe and speckle-tracking analysis software (Cardiac Performance Analysis, TomTec) on 4 chamber (longitudinal strain) and mid short axis (circumferential strain) images.
Results: Left ventricular structure was similar in both preterm born groups at birth and 3months of age. However, offspring of hypertensive pregnancies had reduced early systolic peak velocity at the mitral valve annulus (Septal 4.26 ± 0.13 vs 4.83 ± 0.13 cm/s p=0.006, Lateral 4.17 ± .85 vs 5.03 ±0.68 cm/s p=0.020) at birth and, by 3 months of age, peak left ventricular longitudinal systolic strain (-21.34 ± 2.83 vs -25.00 ± 3.48 p= 0.008) and longitudinal systolic strain rate (-2.53 ± .57 vs 3.20 ± .59 %/s p=0.008) were significantly reduced. This reduction persisted after correction for gestational age (p=0.004), birthweight z score (p=0.021), age at follow up (p= 0.016) and length of hospitalisation at birth (p= 0.013).
Conclusions: Infants born preterm to hypertensive pregnancies show evidence of alteration of cardiac function during the first three months of life compared to preterminfants whose mothers were normotensive. The changes are comparable to those observed in young adult life and highlight the perinatal period as potentially important in the development of the long term cardiac changes associated with in utero exposure to hypertensive pregnancies
- © 2013 by American Heart Association, Inc.