Evaluation of Cardiac Function in Women With a History of Preeclampsia: A Systematic Review and Meta‐Analysis. Issue 22 (19th November 2019)

• Record Type: Journal Article
• Authors: Reddy, Maya; Wright, Leah; Rolnik, Daniel Lorber; Li, Wentao; Mol, Ben Willem; La Gerche, Andre; da SilvaCosta, Fabricio; Wallace, Euan M.; Palmer, Kirsten
• Is Part Of: Journal of the American Heart Association. Volume 8:Issue 22(2019)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2019-11-19
• Subjects: diastolic dysfunction -- left ventricular remodeling -- preeclampsia/pregnancy -- pregnancy and postpartum -- systolic dysfunction; Heart -- Diseases -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; Cerebrovascular disease -- Periodicals; Cardiology -- Periodicals; 616.1
• DOI: 10.1161/JAHA.119.013545
• Languages: English
• ISSNs: 2047-9980

Abstract

Abstract : Background: Women with a history of preeclampsia are at increased risk of cardiovascular morbidity and mortality. However, the underlying mechanisms of disease association, and the ideal method of monitoring this high‐risk group, remains unclear. This review aims to determine whether women with a history of preeclampsia show clinical or subclinical cardiac changes when evaluated with an echocardiogram. Methods and Results: A systematic search of MEDLINE, EMBASE, and CINAHL databases was performed to identify studies that examined cardiac function in women with a history of preeclampsia, in comparison with those with normotensive pregnancies. In the 27 included studies, we found no significant differences between preeclampsia and nonpreeclampsia women with regard to left ventricular ejection fraction, isovolumetric relaxation time, or deceleration time. Women with a history of preeclampsia demonstrated a higher left ventricular mass index and relative wall thickness with a mean difference of 4.25 g/m 2 (95% CI, 2.08, 6.42) and 0.03 (95% CI, 0.01, 0.05), respectively. In comparison with the nonpreeclampsia population, they also demonstrated a lower E/A and a higher E/e′ ratio with a mean difference of −0.08 (95% CI, −0.15, −0.01) and 0.84 (95% CI, 0.41, 1.27), respectively. Conclusions: In comparison with women who had a normotensive pregnancy, women with a history of preeclampsia demonstrated a trend toward altered cardiac structure and function. Further studies with larger sample sizes and consistent echocardiogram reporting with the use of sensitive preclinical markers are required to assess the role of echocardiography in monitoring this high‐risk population group.