Left atrial mechanics following preeclamptic pregnancy

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dc.contributor.authorO’Driscoll, Jamie M.en
dc.contributor.authorMcCarthy, Fergus P.en
dc.contributor.authorGiorgione, Veronicaen
dc.contributor.authorJalaludeen, Navazhen
dc.contributor.authorSeed, Paul T.en
dc.contributor.authorGill, Carolynen
dc.contributor.authorSparkes, Jenieen
dc.contributor.authorPoston, Lucillaen
dc.contributor.authorMarber, Mikeen
dc.contributor.authorShennan, Andrew H.en
dc.contributor.authorChappell, Lucy C.en
dc.contributor.authorThilaganathan, Baskyen
dc.contributor.authorLeeson, Paulen
dc.date.accessioned2025-01-07T16:11:08Z
dc.date.available2025-01-07T16:11:08Z
dc.date.issued2024-07en
dc.description.abstractBACKGROUND: Preterm preeclampsia is a pregnancy complication associated with myocardial dysfunction and premature cardiovascular disease morbidity and mortality. Left atrial (LA) strain is a noninvasive index of left ventricular end diastolic pressure and an early marker of heart failure risk. This study aimed to evaluate LA strain during the postpartum period in participants with and without preterm preeclampsia and to assess whether this varied in the presence of hypertension, cardiac dysfunction or both. METHODS: In this longitudinal cohort study, 321 women from 28 hospitals with preterm preeclampsia (cases) underwent cardiovascular assessment 6 months postpartum. This is a secondary analysis of the PHOEBE study (ISRCTN01879376). An uncomplicated pregnancy control group (n=30) was recruited from a single center for comparison. A full cross-sectional transthoracic echocardiogram was performed, and from these images, the myocardial strain of the left atrium, including reservoir, conduit, and contractile strain, as well as LA stiffness, were calculated. RESULTS: At 6 months postpartum, compared with controls, prior preeclampsia was associated with a significantly attenuated LA reservoir, conduit, and contractile strain, as well as increased LA stiffness (all P<0.001). LA strain was further reduced in preeclamptic women who had and had not developed hypertension, systolic, or diastolic dysfunction at 6 months postpartum (all P<0.05). CONCLUSIONS: LA mechanics were significantly attenuated at 6 months postpartum in participants with preterm preeclampsia, whether or not they remained hypertensive or had evidence of ventricular dysfunction. Further studies are needed to determine whether postnatal LA strain may identify women at greater risk for future cardiovascular disease.en
dc.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationO’Driscoll, J. M., McCarthy, F. P., Giorgione, V., Jalaludeen, N., Seed, P. T., Gill, C., Sparkes, J., Poston, L., Marber, M., Shennan, A. H. and Chappell, L. C. (2024) 'Left atrial mechanics following preeclamptic pregnancy', Hypertension, 81(7), pp.1644-1654. https://doi.org/10.1161/HYPERTENSIONAHA.123.22577en
dc.identifier.doihttps://doi.org/10.1161/HYPERTENSIONAHA.123.22577en
dc.identifier.eissn1524-4563en
dc.identifier.endpage1654en
dc.identifier.issn0194-911Xen
dc.identifier.issued7en
dc.identifier.journaltitleHypertensionen
dc.identifier.startpage1644en
dc.identifier.urihttps://hdl.handle.net/10468/16784
dc.identifier.volume81en
dc.language.isoenen
dc.publisherLippincott Williams & Wilkinsen
dc.relation.ispartofHypertensionen
dc.rights© 2024, American Heart Association, Inc.en
dc.subjectCardiovascular diseasesen
dc.subjectHypertensionen
dc.subjectHeart disease risk factorsen
dc.subjectMorbidityen
dc.subjectPre-eclampsiaen
dc.titleLeft atrial mechanics following preeclamptic pregnancyen
dc.typeArticle (peer-reviewed)en
oaire.citation.issue7en
oaire.citation.volume81en
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