Speckle Tracking Echocardiography in Hypertensive Pregnancy Disorders: A Systematic Review. Issue 8 (August 2020)

• Record Type: Journal Article
• Authors: Moors, Suzanne; van Oostrum, Noortje H. M.; Rabotti, Chiara; Long, Xi; Westerhuis, Michelle E. M. H.; Kemps, Hareld M. C.; Oei, S. Guid; van Laar, Judith O. E. H.
• Is Part Of: Obstetrical & gynecological survey. Volume 75:Issue 8(2020)
• Publication Date: 2020-08
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; Generative organs, Female -- Surgery -- Periodicals; 618
• DOI: 10.1097/OGX.0000000000000811
• Languages: English
• ISSNs: 0029-7828

Abstract

Abstract : Importance: Hypertensive pregnancy disorders (HPDs) are associated with an increased risk of long-term cardiovascular disease. Speckle tracking echocardiography (STE) might be useful in the early detection of preclinical cardiac changes in women with HPDs. Objective: The aim of this study was to study whether STE is a suitable method to detect differences in cardiac function in pregnant women with HPD compared with normotensive pregnant women or between women with a history of a pregnancy complicated by HPD compared with women with a history of an uncomplicated pregnancy. Evidence Acquisition: The databases Medline, EMBASE, and Central were systematically searched for studies comparing cardiac function measured with STE in pregnant women with HPD or women with a history of HPD and women with a history of normotensive pregnancies. Results: The search identified 16 studies, including 870 women with a history of HPD and 693 normotensive controls. Most studies during pregnancy (n = 12/13) found a decreased LV-GLS (left ventricular global longitudinal strain) in HPD compared with normotensive pregnant controls. LV-GRS (left ventricular global radial strain) and LV-GLCS (left ventricular global circumferential strain) are decreased in women with early-onset and severe preeclampsia. Women with a history of early-onset preeclampsia show lasting myocardial changes, with significantly decreased LV-GLS, LV-GLCS, and LV-GRS. Conclusions and Relevance: LV-GLS is significantly decreased in pregnant women with HPD compared with normotensive pregnant women. Other deformation values show a significant decrease in women with severe or early-onset preeclampsia, with lasting myocardial changes after early-onset preeclampsia. Target Audience: Obstetricians and gynecologists, family physicians, cardiologists. Learning Objectives: After participating in this activity, the learner should be better able to identify the test characteristics of STE; describe the differences in STE between HPDs and normotensive pregnant controls; and explain which HPD causes lasting myocardial changes after pregnancy.