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.

Original languageEnglish
JournalUltrasound in Obstetrics & Gynecology
Volume55
Issue6
Pages (from-to)786-792
Number of pages7
ISSN0960-7692
DOIs
Publication statusPublished - Jun 2020

Bibliographical note

This article is protected by copyright. All rights reserved.

    Research areas

  • coronary flow velocity reserve, heart failure, pre-eclampsia, pregnancy, speckle-tracking echocardiography

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