Reduced coronary flow velocity reserve in women with previous pre-eclampsia: link to increased cardiovascular disease risk

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OBJECTIVES: This study evaluates differences in coronary microvascular function between women with early onset preeclampsia (EOPE) and late onset preeclampsia (LOPE) and age-matched normotensive controls approximately 12 years after index pregnancy and the relation between microvascular function and myocardial deformation in these subjects.

METHODS: We evaluated the coronary flow velocity reserve (CFVR) by Doppler echocardiography in 88 women who gave birth at Department of Gynecology and Obstetrics, Randers Regional Hospital between 1998-2008. The women were grouped as EOPE (n=29), LOPE (n=20) and previous normotensive pregnancies (n=39).

RESULTS: The resting coronary flow velocities were comparable between groups (p=0.55), whereas the peak hyperemic flow velocity was significantly lower in EOPE than LOPE (p<0.01) and controls (p<0.0001). Subsequently, mean CFVR was significantly lower in the EOPE group than in the LOPE group (p<0.01) and in the control group (p<0.0001). We wound CFVR < 2.5 in 48% EOPE women, 20% of LOPE women and 8% of controls (p<0.01). We found a significant positive relation between gestational age at PE diagnosis and CFVR (β1 = 1.8 (95% CI 0.8-2.9), p < 0.01). This relation remained significant after adjustment for cardiac hazards in terms of mean arterial blood pressure, HbA1c-level, BMI and smoking status (p < 0.05). We found a significant relation between left ventricular global longitudinal strain (LVGLS) and CFVR in previous PE women (β1 = -1.5 (95% CI -2.2;-0.9), R2 = 0.33, p < 0.0001).

CONCLUSIONS: Early gestational age at PE onset was associated with CFVR 12 years after delivery both as a continuous variable and categorized by EOPE/LOPE distinction. Nearly 50% of women with previous EOPE had CFVR < 2.5. Reduced CFVR in previous PE subjects was associated with subclinical myocardial dysfunction in term of reduced LVGLS. This article is protected by copyright. All rights reserved.

OriginalsprogEngelsk
TidsskriftUltrasound in Obstetrics & Gynecology
Vol/bind55
Nummer6
Sider (fra-til)786-792
Antal sider7
ISSN0960-7692
DOI
StatusUdgivet - jun. 2020

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