Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands.
CARIM School for Cardiovascular Diseases, Maastricht University, 6229 ER Maastricht, The Netherlands.
Biomolecules. 2022 Mar 7;12(3):415. doi: 10.3390/biom12030415.
Preeclampsia is a maternal hypertensive disease, complicating 2-8% of all pregnancies. It has been linked to a 2-7-fold increased risk for the development of cardiovascular disease, including heart failure, later in life. A total of 40% of formerly preeclamptic women develop preclinical heart failure, which may further deteriorate into clinical heart failure. Noninvasive cardiac imaging could assist in the early detection of myocardial abnormalities, especially in the preclinical stage, when these changes are likely to be reversible. Moreover, imaging studies can improve our insights into the relationship between preeclampsia and heart failure and can be used for monitoring. Cardiac ultrasound is used to assess quantitative changes, including the left ventricular cavity volume and wall thickness, myocardial mass, systolic and diastolic function, and strain. Cardiac magnetic resonance imaging may be of additional diagnostic value to assess diffuse and focal fibrosis and perfusion. After preeclampsia, sustained elevated myocardial mass along with reduced myocardial circumferential and longitudinal strain and decreased diastolic function is reported. These findings are consistent with the early phases of heart failure, referred to as preclinical (asymptomatic) or B-stage heart failure. In this review, we will provide an up-to-date overview of the potential of cardiac magnetic resonance imaging and echocardiography in identifying formerly preeclamptic women who are at high risk for developing heart failure. The potential contribution to early cardiac screening of women with a history of preeclampsia and the pros and cons of these imaging modalities are outlined. Finally, recommendations for future research are presented.
子痫前期是一种孕妇高血压疾病，影响所有妊娠的 2-8%。它与心血管疾病（包括心力衰竭）的发生风险增加 2-7 倍有关，尤其是在以后的生活中。多达 40%的以前患有子痫前期的女性会发展为临床前心力衰竭，这可能进一步恶化至临床心力衰竭。非侵入性心脏成像可以帮助早期发现心肌异常，特别是在临床前阶段，此时这些变化可能是可逆的。此外，影像学研究可以提高我们对子痫前期和心力衰竭之间关系的认识，并可用于监测。心脏超声用于评估定量变化，包括左心室腔容积和壁厚度、心肌质量、收缩和舒张功能以及应变。心脏磁共振成像可能对评估弥漫性和局灶性纤维化和灌注具有额外的诊断价值。子痫前期后，报告心肌质量持续升高，同时伴有心肌圆周和纵向应变减少以及舒张功能降低。这些发现与心力衰竭的早期阶段一致，称为临床前（无症状）或 B 期心力衰竭。在这篇综述中，我们将提供心脏磁共振成像和超声心动图在识别有发生心力衰竭高风险的以前患有子痫前期的女性方面的最新概述。这些成像方式在对有子痫前期病史的女性进行早期心脏筛查中的潜在贡献以及这些成像方式的优缺点进行了概述。最后，提出了未来研究的建议。
