Skip to main content
SpringerLink
Log in

The evaluation of ventricular functions by speckle tracking echocardiography in preeclamptic patients

  • Original Paper
  • Published:
The International Journal of Cardiovascular Imaging Aims and scope Submit manuscript

Abstract

Preeclampsia is a maternal disorder of pregnancy characterized by concomitant increase in preload and afterload with end organ dysfunction. The aim of our study is to evaluate left ventricular (LV) and right ventricular (RV) functions with speckle tracking echocardiography in preeclamptic patients. Fifty-five preeclamptic (mean age: 30.7 ± 5.9 years) and 35 healthy pregnant women (mean age: 28.8 ± 5.7 years) of the same race, similar age and gestational week were consecutively included. The diagnosis of preeclampsia was based on the criteria proposed by the American College of Obstetricians and Gynecologists. LV and RV functions were assessed by both conventional and speckle tracking echocardiography after the 30th gestational week and at the postpartum 6th months. The preeclamptic patients had significantly larger left atrium, thicker interventricular septum, higher systolic pulmonary artery pressure and mitral E/e′ ratio compared to controls during pregnancy while LV ejection fraction was similar. Preeclamptic patients had significantly lower LV and RV global longitudinal strain (GLS) during pregnancy compared to controls (− 18.0 ± 2.6% vs. − 19.8 ± 2.1% p = 0.001 and − 26.7 ± 3.3% vs. 28.9 ± 3.3% p = 0.002, respectively). In the postpartum period, while LVGLS values of preeclamptic patients increased significantly (− 18.0 ± 2.6% vs. − 20.4 ± 2.4% p < 0.001) and became similar to those of controls at the sixth month, the RVGLS decreased significantly (− 26.7 ± 3.3% vs. − 25.8 ± 2.7% p = 0.003) making the difference in RVGLS between the preeclamptic patients and controls more prominent. Preeclampsia may impair LV and RV function. Long-term follow up with larger sample is needed to determine the clinical relevance of the observed changes in strain.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data availability

The authors have full control of all primary data and agree to allow the journal to review their data if requested.

Code availability

Available upon request.

References

  1. Regitz-Zagrosek V, Roos-Hesselink JW, Bauersachs J, Blomström-Lundqvist C, Cífková R, De Bonis M, Iung B, Johnson MR, Kintscher U, Kranke P, Lang IM, Morais J, Pieper PG, Presbitero P, Price S, Rosano GMC, Seeland U, Simoncini T, Swan L, Warnes CA, ESC Scientific Document Group (2018) 2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy. Eur Heart J 39:3165–3241

    Article  Google Scholar 

  2. Hutcheon JA, Lisonkova S, Joseph KS (2011) Epidemiology of pre-eclampsia and the other hypertensive disorders of pregnancy. Best Pract Res Clin Obstet Gynaecol 25:391–403

    Article  Google Scholar 

  3. Tranquilli AL, Dekker G, Magee L, Roberts J, Sibai BM, Steyn W, Zeeman GG, Brown MA (2014) The classification, diagnosis and management of the hypertensive disorders of pregnancy: a revised statement from the ISSHP. Pregnancy Hypertens 4:97–104

    Article  CAS  Google Scholar 

  4. Chapman AB, Abraham WT, Zamudio S, Coffin C, Merouani A, Young D, Johnson A, Osorio F, Goldberg C, Moore LG, Dahms T, Schrier RW (1998) Temporal relationships between hormonal and hemodynamic changes in early human pregnancy. Kidney Int 54:2056–2063

    Article  CAS  Google Scholar 

  5. Orabona R, Sciatti E, Prefumo F, Vizzardi E, Bonadei I, Valcamonico A, Metra M, Frusca T (2018) Pre-eclampsia and heart failure: a close relationship. Ultrasound Obstet Gynecol 52:297–301

    Article  CAS  Google Scholar 

  6. Tyldum EV, Backe B, Støylen A, Slørdahl SA (2012) Maternal left ventricular and endothelial functions in preeclampsia. Acta Obstet Gynecol Scand 91:566–573

    Article  Google Scholar 

  7. Shahul S, Rhee J, Hacker MR, Gulati G, Mitchell JD, Hess P, Mahmood F, Arany Z, Rana S, Talmor D (2012) Subclinical left ventricular dysfunction in preeclamptic women with preserved left ventricular ejection fraction: a 2D speckle-tracking imaging study. Circ Cardiovasc Imaging 5:734–739

    Article  Google Scholar 

  8. American College of Obstetricians and Gynecologists; Task Force on Hypertension in Pregnancy (2013) Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstet Gynecol 122:1122–1131

    Article  Google Scholar 

  9. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P, Muraru D, Picard MH, Rietzschel ER, Rudski L, Spencer KT, Tsang W, Voigt JU (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 28:1–39

    Article  Google Scholar 

  10. Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, Solomon SD, Louie EK, Schiller NB (2010) Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 23:685–713

    Article  Google Scholar 

  11. Delgado V, Ypenburg C, van Bommel RJ, Tops LF, Mollema SA, Marsan NA, Bleeker GB, Schalij MJ, Bax JJ (2008) Assessment of left ventricular dyssynchrony by speckle tracking strain imaging comparison between longitudinal, circumferential, and radial strain in cardiac resynchronization therapy. J Am Coll Cardiol 51:1944–1952

    Article  Google Scholar 

  12. Donal E, Tournoux F, Leclercq C, De Place C, Solnon A, Derumeaux G, Mabo P, Cohen-Solal A, Daubert JC (2008) Assessment of longitudinal and radial ventricular dyssynchrony in ischemic and nonischemic chronic systolic heart failure: a two-dimensional echocardiographic speckle-tracking strain study. J Am Soc Echocardiogr 21:58–65

    Article  Google Scholar 

  13. Ando T, Kaur R, Holmes AA, Brusati A, Fujikura K, Taub CC (2015) Physiological adaptation of the left ventricle during the second and third trimesters of a healthy pregnancy: a speckle tracking echocardiography study. Am J Cardiovasc Dis 5:119–126

    PubMed  PubMed Central  Google Scholar 

  14. Melchiorre K, Sharma R, Thilaganathan B (2014) Cardiovascular implications in preeclampsia: an overview. Circulation 130:703–714

    Article  Google Scholar 

  15. Melchiorre K, Sutherland GR, Baltabaeva A, Liberati M, Thilaganathan B (2011) Maternal cardiac dysfunction and remodeling in women with preeclampsia at term. Hypertension 57:85–93

    Article  CAS  Google Scholar 

  16. Melchiorre K, Sutherland GR, Watt-Coote I, Liberati M, Thilaganathan B (2012) Severe myocardial impairment and chamber dysfunction in preterm preeclampsia. Hypertens Pregnancy 31:454–471

    Article  Google Scholar 

  17. Wisløff U, Loennechen JP, Currie S, Smith GL, Ellingsen Ø (2002) Aerobic exercise reduces cardiomyocyte hypertrophy and increases contractility, Ca2+ sensitivity and SERCA-2 in rat after myocardial infarction. Cardiovasc Res 54:162–174

    Article  Google Scholar 

  18. Melchiorre K, Sutherland GR, Liberati M, Thilaganathan B (2011) Preeclampsia is associated with persistent postpartum cardiovascular impairment. Hypertension 58:709–715

    Article  CAS  Google Scholar 

  19. Ghi T, Degli Esposti D, Montaguti E, Rosticci M, De Musso F, Youssef A, Salsi G, Pilu G, Borghi C, Rizzo N (2014) Post-partum evaluation of maternal cardiac function after severe preeclampsia. J Matern Fetal Neonatal Med 27:696–701

    Article  Google Scholar 

  20. Çağlar FN, Ozde C, Bostancı E, Çağlar İM, Çiftçi S, Unğan İ, Demir B, Karakaya O (2016) Assessment of right heart function in preeclampsia by echocardiography. Pregnancy Hypertens 6:89–94

    Article  Google Scholar 

  21. Aardenburg R, Spaanderman ME, van Eijndhoven HW, de Leeuw PW, Peeters LL (2005) Formerly preeclamptic women with a subnormal plasma volume are unable to maintain a rise in stroke volume during moderate exercise. J Soc Gynecol Investig 12:599–603

    Article  Google Scholar 

Download references

Funding

None.

Author information

Authors and Affiliations

  1. Department of Cardiology, Marmara University Faculty of Medicine, Istanbul, Turkey

    Ashok Paudel, Kursat Tigen, Ipek Yildiz, Altug Cincin, Murat Sunbul, Emre Gurel, Nurten Sayar & Beste Ozben

  2. Department of Obstetrics and Gynecology, Marmara University Faculty of Medicine, Istanbul, Turkey

    Tevfik Yoldemir & Mehmet Guclu

Authors
  1. Ashok Paudel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kursat Tigen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tevfik Yoldemir
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mehmet Guclu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ipek Yildiz
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Altug Cincin
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Murat Sunbul
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Emre Gurel
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Nurten Sayar
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Beste Ozben
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conception and design. Dr. Paudel, Dr. Tigen, Dr. Yoldemir and Dr. Ozben were the primary investigators and were responsible from the study design, data acquisition and drafting of the manuscript. Dr. Yoldemir and Dr. Guclu were responsible for the patient recruitment. Dr. Yildiz, Dr. Cincin, Dr. Sunbul, Dr. Gurel and Dr. Sayar helped in data analysis and critically revised the manuscript. All authors have read and approved the final manuscript.

Corresponding author

Correspondence to Beste Ozben.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical approval

The study has been approved by the local ethics committee and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

All persons gave their informed consent prior to their inclusion in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Paudel, A., Tigen, K., Yoldemir, T. et al. The evaluation of ventricular functions by speckle tracking echocardiography in preeclamptic patients. Int J Cardiovasc Imaging 36, 1689–1694 (2020). https://doi.org/10.1007/s10554-020-01872-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10554-020-01872-y

Keywords

Search

Navigation