Evaluation of Cardiac Function in Women With a History of Preeclampsia: A Systematic Review and Meta‐Analysis
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 his...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2019-11-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.119.013545 |
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| author | Maya Reddy Leah Wright Daniel Lorber Rolnik Wentao Li Ben Willem Mol Andre La Gerche Fabricio da SilvaCosta Euan M. Wallace Kirsten Palmer |
| author_facet | Maya Reddy Leah Wright Daniel Lorber Rolnik Wentao Li Ben Willem Mol Andre La Gerche Fabricio da SilvaCosta Euan M. Wallace Kirsten Palmer |
| author_sort | Maya Reddy |
| collection | DOAJ |
| description | 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/m2 (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. |
| first_indexed | 2024-04-13T16:30:57Z |
| format | Article |
| id | doaj.art-df010ddcba7b4d6491aa2f7e396848ee |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-13T16:30:57Z |
| publishDate | 2019-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-df010ddcba7b4d6491aa2f7e396848ee2022-12-22T02:39:35ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802019-11-0182210.1161/JAHA.119.013545Evaluation of Cardiac Function in Women With a History of Preeclampsia: A Systematic Review and Meta‐AnalysisMaya Reddy0Leah Wright1Daniel Lorber Rolnik2Wentao Li3Ben Willem Mol4Andre La Gerche5Fabricio da SilvaCosta6Euan M. Wallace7Kirsten Palmer8Department of Obstetrics and Gynaecology Monash University Melbourne Victoria AustraliaBaker Heart and Diabetes Institute Melbourne Victoria AustraliaDepartment of Obstetrics and Gynaecology Monash University Melbourne Victoria AustraliaDepartment of Obstetrics and Gynaecology Monash University Melbourne Victoria AustraliaDepartment of Obstetrics and Gynaecology Monash University Melbourne Victoria AustraliaBaker Heart and Diabetes Institute Melbourne Victoria AustraliaDepartment of Obstetrics and Gynaecology Monash University Melbourne Victoria AustraliaDepartment of Obstetrics and Gynaecology Monash University Melbourne Victoria AustraliaDepartment of Obstetrics and Gynaecology Monash University Melbourne Victoria AustraliaBackground 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/m2 (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.https://www.ahajournals.org/doi/10.1161/JAHA.119.013545diastolic dysfunctionleft ventricular remodelingpreeclampsia/pregnancypregnancy and postpartumsystolic dysfunction |
| spellingShingle | Maya Reddy Leah Wright Daniel Lorber Rolnik Wentao Li Ben Willem Mol Andre La Gerche Fabricio da SilvaCosta Euan M. Wallace Kirsten Palmer Evaluation of Cardiac Function in Women With a History of Preeclampsia: A Systematic Review and Meta‐Analysis Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease diastolic dysfunction left ventricular remodeling preeclampsia/pregnancy pregnancy and postpartum systolic dysfunction |
| title | Evaluation of Cardiac Function in Women With a History of Preeclampsia: A Systematic Review and Meta‐Analysis |
| title_full | Evaluation of Cardiac Function in Women With a History of Preeclampsia: A Systematic Review and Meta‐Analysis |
| title_fullStr | Evaluation of Cardiac Function in Women With a History of Preeclampsia: A Systematic Review and Meta‐Analysis |
| title_full_unstemmed | Evaluation of Cardiac Function in Women With a History of Preeclampsia: A Systematic Review and Meta‐Analysis |
| title_short | Evaluation of Cardiac Function in Women With a History of Preeclampsia: A Systematic Review and Meta‐Analysis |
| title_sort | evaluation of cardiac function in women with a history of preeclampsia a systematic review and meta analysis |
| topic | diastolic dysfunction left ventricular remodeling preeclampsia/pregnancy pregnancy and postpartum systolic dysfunction |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.119.013545 |
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