4 years ago

Decreased endothelial function and increased subclinical heart failure in women, many years after pre-eclampsia

S. M. J. van Kuijk, L. Geerts, M. E. A. Spaanderman, W. M. Heidema, M. J. van der Vlugt, A. P. van Dijk, M. J. J. M. Sengers, J. van Neer, N. M. Breetveld, R. R. Scholten, H. P. Brunner-La Rocca, C. Ghossein-Doha
Objectives Pre-eclampsia (PE) is associated with both postpartum endothelial dysfunction and asymptomatic structural heart alterations consistent with heart failure stage B (HF-B). In this study we assessed the relation between endothelial function, by means of flow-mediated dilation (FMD), and HF-B at 4 years postpartum. Methods In 67 formerly PE women and 37 healthy parous controls, we ultrasonographically assessed cardiac function, geometry and FMD. HF-B was diagnosed as left ventricular hypertrophy (left ventricular mass index (LVMi) >95 g/m2), concentric remodelling (relative wall thickness (RWT) >0.42 and LVMi ≤95 g/m2), mild systolic dysfunction (left ventricular ejection fraction (LVEF) >40 and <55%) or asymptomatic valvular disease. Endothelial function was assessed by brachial artery FMD measurement. Results The prevalence of HF-B amongst formerly PE was 3-fold higher than that observed in controls (25% vs 8%, p ≤ 0.05), while FMD was lower in formerly PE compared with controls (6.12% vs 8.22%, p ≤ 0.01). However, HF-B did not relate to shallow FMD in formerly PE women. Conclusions Years after pregnancy, former PE women have lower FMD and more often HF-B compared with healthy parous controls. Nonetheless, HF-B did not relate to reduced FMD.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1002/uog.17534

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