Children's Hospital University of Helsinki and Helsinki University Hospital Helsinki Finland.
Minerva Foundation Institute for Medical Research Helsinki Finland.
J Am Heart Assoc. 2024 Aug 6;13(15):e034494. doi: 10.1161/JAHA.124.034494. Epub 2024 Jul 16.
We evaluated how elevated blood pressure in children exposed to preeclampsia (PE) impacted on their cardiac structure and function, as well as relations with maternal, gestational, and perinatal factors and child body size and composition.
A total of 182 PE (46 early-onset preeclampsia) and 85 unexposed (non-PE) children were examined in the FINNCARE study 8 to 12 years after the index pregnancy with echocardiography; office, central, and 24-hour ambulatory blood pressures; and body anthropometrics and composition. PE children had lower right ventricular basal sphericity index (mean difference, -0.26 95% CI, -0.39 to -0.12) and lower mitral lateral '-wave peak velocity (-1.4 cm/s [95% CI, -2.1 to -0.6]), as well as higher to ' ratio (0.40 [95% CI, 0.15-0.65]) and indexed tricuspid annular plane systolic excursion (0.03 [95% CI, 0.01-0.05]) compared with non-PE children. These differences were accentuated in early-onset PE children. Left ventricular mass (LVM) or left atrial volume were not different between PE and non-PE children. Lean body mass, body fat percentage, and 24-hour systolic blood pressure were independent predictors of LVM. Lean body mass and body fat percentage were independent predictors of left atrial volume. No significant associations between LVM or left atrial volume and maternal, gestational, or perinatal parameters were found.
Preadolescent PE children display a more globular-shaped right ventricle with higher longitudinal systolic displacement as well as mildly altered diastolic indices, with the alterations being pronounced in early-onset preeclampsia. Lean body mass and adiposity are independently related with LVM and left atrial volume, and systolic blood pressure with LVM in both PE and non-PE children. These unfavorable associations indicate remodeling of cardiac structure in young children also reflected in mild functional changes in PE children.
URL: https://www.clinicaltrials.gov; unique identifier: NCT04676295.
我们评估了患有先兆子痫（PE）的儿童的血压升高对其心脏结构和功能的影响，以及与母亲、妊娠和围产期因素以及儿童身体大小和组成的关系。
在 FINNCARE 研究中，共有 182 名患有 PE（46 名早发型子痫前期）和 85 名未暴露（非 PE）的儿童在指数妊娠后 8 至 12 年接受了超声心动图检查；诊室、中心和 24 小时动态血压监测；以及身体人体测量和组成。PE 患儿的右心室基底球体指数较低（平均差异，-0.26；95%CI，-0.39 至-0.12）和二尖瓣外侧'-波峰值速度较低（-1.4cm/s；95%CI，-2.1 至-0.6），以及更高的 至 '比值（0.40；95%CI，0.15-0.65）和指数化三尖瓣环平面收缩期位移（0.03；95%CI，0.01-0.05），而非 PE 患儿。这些差异在早发型 PE 患儿中更为明显。PE 和非 PE 患儿的左心室质量（LVM）或左心房容积无差异。瘦体重、体脂百分比和 24 小时收缩压是 LVM 的独立预测因子。瘦体重和体脂百分比是左心房容积的独立预测因子。未发现 LVM 或左心房容积与母亲、妊娠或围产期参数之间存在显著相关性。
青春期前的 PE 患儿表现出更球形的右心室，具有更高的纵向收缩位移以及轻度改变的舒张指数，在早发型子痫前期中这些改变更为明显。瘦体重和肥胖与 LVM 和左心房容积独立相关，PE 和非 PE 儿童的收缩压与 LVM 相关。这些不利的关联表明，心脏结构的重塑也反映在 PE 患儿的轻度功能变化中。
