Long-term follow-up of women with early onset pre-eclampsia shows subclinical impairment of the left ventricular function by two-dimensional speckle tracking echocardiography.

OBJECTIVES: This study compares differences in the long-term myocardial function between women with early (EOPE) and late onset preeclampsia (LOPE) and age matched normotensive controls using two-dimensional speckle tracking echocardiography.

METHODS: The study population comprised 93 women who gave birth at Department of Gynecology and Obstetrics, Randers Regional Hospital between 1998 and 2008. The women were grouped as EOPE (n = 31), LOPE (n = 22), and women with previous normotensive pregnancies (n = 40). All women underwent comprehensive blinded echocardiographic assessment of myocardial function.

RESULTS: The median time since delivery was 12 years [9;15]. Left ventricular (LV) ejection fraction did not differ between groups. In contrast, LV longitudinal systolic myocardial function by LV global longitudinal strain (LVGLS) magnitude was significantly lower in EOPE women than controls (-18 ± 3% versus -21 ± 2%, p < 0.001) and LOPE women (-18 ± 3% versus -21 ± 2%, p < 0.01). In alignment with systolic parameters, the diastolic filling pattern indicated more restrictive filling pattern in EOPE women than controls and LOPE women. Thus, EOPE women had lower septal e' velocities leading to lower mean e' and subsequently higher E/e' ratio (p < 0.01) than controls and LOPE women. LVGLS was the echocardiographic parameter with the strongest association with EOPE in ROC curves.

CONCLUSIONS: Women with a history of EOPE are more likely to have subclinical impairment of left ventricular function 12 years after PE than are those with a history of LOPE and controls. LVGLS was the echocardiographic parameter with the strongest association with EOPE.