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Hypertensive Disorders of Pregnancy and Heart Failure

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Hypertension and Heart Failure

Part of the book series: Updates in Hypertension and Cardiovascular Protection ((UHCP))

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Abstract

Hypertensive disorders of pregnancy (HDP) are one of the leading causes of maternal, fetal, and neonatal morbidity and mortality. They can induce heart failure (HF) in the ante-, intra- or postpartum period.

History of HDP predisposes women to worse left ventricle diastolic function even some decades after pregnancy, but the pathophysiology of this deleterious impact is still unknown.

Compared with normotensive control pregnancies, women with HDP demonstrate greater antepartum left atrium volume, increased left ventricle wall thickness, larger inferior vena cava diameter, lower early diastolic septal and lateral mitral annular velocity (e′), and decreased index of long axis contractility. The laboratory tests of women with HDP show an increase of peripartum brain natriuretic peptide/N-terminal pro-brain natriuretic peptide (BNP/NT-proBNP) and other potential biomarkers (glycoprotein growth factor activin A, angiotensin II type 1 receptor autoantibodies, soluble human leukocyte antigen G, interleukin-6, tumor necrosis factor-α, etc.).

Strategies for prevention and treatment of HDP-associated HF must cover both pregnancy and the postpartum period. Possible interventions during pregnancy include first-trimester screening for HDP, lifestyle changes, aspirin administration in women at high or moderate risk of preeclampsia, and early referral to specialist care. Structured cardiovascular (CV) follow-up, limitation of sodium intake, treatment with renin-angiotensin system blockers, and regular assessment and possible management of CV risk should be employed postpartum.

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Authors and Affiliations

  1. Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer University Hospital, Prague, Czech Republic

    Larysa Strilchuk & Renata Cífková

  2. Department of Therapy №1, Medical Diagnostics, Hematology and Transfusiology, Lviv Danylo Halytsky National Medical University, Lviv, Ukraine

    Larysa Strilchuk

  3. Department of Medicine II, Charles University in Prague, First Faculty of Medicine, Prague, Czech Republic

    Renata Cífková

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  1. Larysa Strilchuk
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Correspondence to Renata Cífková .

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Editors and Affiliations

  1. Carol Davila University of Medicine and Pharmacy, Bucharest, Bucuresti, Romania

    Maria Dorobantu

  2. Department of Pharmacology, Toxicology and Clinical Psychopharmacology Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania

    Victor Voicu

  3. University of Milano-Bicocca, Milano, Italy

    Guido Grassi

  4. Dept of Clinical and Experimental Sci, University of Brescia, Brescia, Italy

    Enrico Agabiti-Rosei

  5. University of Milano-Bicocca, Milano, Italy

    Giuseppe Mancia

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Strilchuk, L., Cífková, R. (2023). Hypertensive Disorders of Pregnancy and Heart Failure. In: Dorobantu, M., Voicu, V., Grassi, G., Agabiti-Rosei, E., Mancia, G. (eds) Hypertension and Heart Failure. Updates in Hypertension and Cardiovascular Protection. Springer, Cham. https://doi.org/10.1007/978-3-031-39315-0_31

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