Abstract 19144: Echocardiographic Assessment of Structural and Hemodynamic Changes in Hypertensive Pregnancy
Introduction: Pregnancy induces dramatic cardiovascular changes to meet the metabolic needs for mother and fetus. Eccentric left ventricular hypertrophy (LVH) is known as the normal cardiac response to handle the increasing circulatory volume during pregnancy. Cardiac adaptation would be modified in pregnancy complicated by hypertension.
Methods: Data from 193 consecutive pregnant women were analyzed. Clinical and echocardiographic data were compared in normotensive and hypertensive women.
Results: Left ventricular mass index was significantly higher in hypertensive women than normotensive ones (87±17 vs 78±16, p<0.001, Fig.1A). Diastolic function measured by the ratio of early mitral blood to annular velocity (E/E’) was impaired in hypertensive women (11.0±3.0 vs 9.2±2.5, p<0.001, Fig.1B). Such change was more prominent in women with gestational hypertension (GHW) than those with chronic hypertension (CHW). Obesity was independent factor associated with LVH in both normotensive and hypertensive women (Fig.1C). Overt eccentric LVH was more frequent than concentric remodeling/hypertrophy (25% vs 8.4%) in GHW, while the result was opposite in CHW (14% vs 23%, Fig.1D).
Conclusion: Hypertensive pregnancy is associated with significant LVH and diastolic dysfunction. Obesity accentuates hypertension-related cardiac remodeling. While eccentric LVH is prominent in GHW, pre-existing chronic hypertension appears to induce concentric LV geometry.
Author Disclosures: M. Kim: Research Grant; Significant; the Korean Society of Echocardiography (2011). K. Cho: None. S. Yoon: None. J. Choi: None. M. Shin: None.
- © 2015 by American Heart Association, Inc.