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Pre-eclampsia: an important risk factor for asymptomatic heart failure.
Ghossein-Doha, C; van Neer, J; Wissink, B; Breetveld, N M; de Windt, L J; van Dijk, A P J; van der Vlugt, M J; Janssen, M C H; Heidema, W M; Scholten, R R; Spaanderman, M E A.
Afiliación
  • Ghossein-Doha C; Department of Obstetrics and Gynaecology, Maastricht University Medical Centre (MUMC), Maastricht, The Netherlands.
  • van Neer J; Department of Obstetrics and Gynaecology, Maastricht University Medical Centre (MUMC), Maastricht, The Netherlands.
  • Wissink B; Department of Obstetrics and Gynaecology, Maastricht University Medical Centre (MUMC), Maastricht, The Netherlands.
  • Breetveld NM; Department of Obstetrics and Gynaecology, Maastricht University Medical Centre (MUMC), Maastricht, The Netherlands.
  • de Windt LJ; Department of Cardiology, MUMC, Maastricht, The Netherlands.
  • van Dijk AP; Department of Cardiology, Radboud UMC, Nijmegen, The Netherlands.
  • van der Vlugt MJ; Department of Cardiology, Radboud UMC, Nijmegen, The Netherlands.
  • Janssen MC; Department of Internal Medicine, Radboud UMC, Nijmegen, The Netherlands.
  • Heidema WM; Department of Obstetrics and Gynaecology, Radboud UMC, Nijmegen, The Netherlands.
  • Scholten RR; Department of Obstetrics and Gynaecology, Radboud UMC, Nijmegen, The Netherlands.
  • Spaanderman ME; Department of Obstetrics and Gynaecology, Maastricht University Medical Centre (MUMC), Maastricht, The Netherlands.
Ultrasound Obstet Gynecol ; 49(1): 143-149, 2017 Jan.
Article en En | MEDLINE | ID: mdl-27804179
OBJECTIVES: Pre-eclampsia (PE) is associated with both postpartum structural asymptomatic heart disease (i.e. heart failure Stage B (HF-B)) and conventional cardiovascular (CV) risk factors. We aimed to evaluate the extent to which PE, adjusted for conventional CV risk factors, is associated independently with asymptomatic cardiac abnormalities postpartum. METHODS: In this cross-sectional cohort study, 107 formerly pre-eclamptic women and 41 women with uneventful previous pregnancy (controls) were invited for CV risk assessment 4-10 years postpartum. This included cardiac ultrasound, blood pressure (BP) measurement and evaluation of metabolic syndrome determinants. Asymptomatic structural and functional cardiac abnormalities were classified as HF-B, according to the American Heart Association guidelines. Prehypertension was defined as systolic BP of 120-139 mmHg and/or diastolic BP of 80-89 mmHg. Univariate and multivariate regression analyses were performed to calculate associations of PE and conventional risk factors with HF-B. RESULTS: The prevalence of asymptomatic HF-B was approximately 3.5-fold higher in the PE group compared with controls (25% vs 7%, P < 0.01); 67% of this group had concentric remodeling and 22% had mildly impaired ejection fraction. After adjustment for postpartum interval, hypertension and high-density lipoprotein, PE was significantly associated with HF-B (adjusted odds ratio, 4.4 (95% CI, 1.0-19.1)). Moreover, in the formerly pre-eclamptic group, prehypertension was associated significantly with HF-B (odds ratio, 4.3 (95% CI, 1.4-12.7)), while metabolic syndrome determinants were not. CONCLUSION: PE is associated with a four-fold increased female-specific risk of asymptomatic cardiac abnormalities. Prehypertension apparently increases this risk significantly, while metabolic syndrome determinants do not. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Preeclampsia / Corazón / Insuficiencia Cardíaca Tipo de estudio: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Risk_factors_studies Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Ultrasound Obstet Gynecol Asunto de la revista: DIAGNOSTICO POR IMAGEM / GINECOLOGIA / OBSTETRICIA Año: 2017 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Preeclampsia / Corazón / Insuficiencia Cardíaca Tipo de estudio: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Risk_factors_studies Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Ultrasound Obstet Gynecol Asunto de la revista: DIAGNOSTICO POR IMAGEM / GINECOLOGIA / OBSTETRICIA Año: 2017 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido