Vaddamani Sindhura, Keepanasseril Anish, Pillai Ajith Ananthakrishna, Kumar Binay
Department of Obstetrics & Gynecology, Jawaharlal Institute of Post-graduate Medical Education & Research, Puducherry 605006, India.
Department of Obstetrics & Gynecology, Jawaharlal Institute of Post-graduate Medical Education & Research, Puducherry 605006, India.
Pregnancy Hypertens. 2017 Oct;10:247-250. doi: 10.1016/j.preghy.2017.10.010. Epub 2017 Oct 25.
To compare the cardiovascular changes associated with early onset (EOPE) and late onset (LOPE) subtypes of preeclampsia.
A prospective matched cross-sectional study involving 50 women each with early and late onset subtypes of preeclampsia conducted in a tertiary hospital in South India. Cardiac function and remodelling were assessed by conventional 2D, M-mode and doppler echocardiography.
Women with EOPE had a significantly more altered left ventricular (LV) geometry, global LV diastolic dysfunction, impairment in myocardial contractility (40% vs. 24%) and a higher total vascular resistance index (863.0 vs 704.0 dynes/s/cm/m) compared to LOPE. Stroke volume index (55.3 vs. 62.2 ml/m) and cardiac work index (520.7 vs. 584.9mmHg×L/min/m) were higher in women with LOPE. However, the systolic function was found to be preserved in the LV in both the groups.
Women with EOPE have a more severe cardiac impairment than those with LOPE. The difference in the hemodynamic indices may provide a chance to tailor patient-specific treatment strategies to improve the pregnancy outcome as well as in early identification and initiation of preventive measures for those at risk of cardiovascular diseases later in life.
Adaptation of the heart in women with early onset subtype differs with that of late onset subtype of preeclampsia. Total vascular resistance is higher in early onset group compared to late onset group having a higher cardiac output. These differences in the hemodynamic indices may provide a chance to tailor patient-specific treatment strategies to improve the pregnancy outcome as well as in early identification and initiation of preventive measures for those at risk of cardiovascular diseases later in life.
比较早发型（EOPE）和晚发型（LOPE）子痫前期亚型相关的心血管变化。
在印度南部一家三级医院进行的前瞻性匹配横断面研究，纳入50例早发型和晚发型子痫前期亚型的女性。通过传统二维、M型和多普勒超声心动图评估心脏功能和重塑情况。
与晚发型子痫前期相比，早发型子痫前期女性的左心室（LV）几何形态改变更显著，整体左心室舒张功能障碍，心肌收缩力受损（40%对24%），总血管阻力指数更高（863.0对704.0达因/秒/厘米/米）。晚发型子痫前期女性的每搏输出量指数（55.3对62.2毫升/米）和心脏作功指数（520.7对584.9毫米汞柱×升/分钟/米）更高。然而，两组左心室的收缩功能均得以保留。
早发型子痫前期女性的心脏损害比晚发型子痫前期女性更严重。血流动力学指标的差异可能为制定针对患者的治疗策略提供机会，以改善妊娠结局，并尽早识别和启动针对日后有心血管疾病风险者的预防措施。
早发型子痫前期亚型女性的心脏适应性与晚发型子痫前期亚型不同。早发型组的总血管阻力高于晚发型组，而晚发型组的心输出量更高。这些血流动力学指标的差异可能为制定针对患者的治疗策略提供机会，以改善妊娠结局，并尽早识别和启动针对日后有心血管疾病风险者的预防措施。
