Pre-eclampsia: an important risk factor for asymptomatic heart failure
Pre-eclampsia: an important risk factor for asymptomatic heart failure
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DOI：
10.1002/uog.17343
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发表时间：
2017-01-01
影响因子：
7.1
通讯作者：
Spaanderman, M. E. A.
中科院分区：
文献类型：
--
作者：
Ghossein-Doha, C.;Van Neer, J.;Spaanderman, M. E. A.
目的子痫前期（PE）与产后结构性无症状心脏病（即心力衰竭B期（HF-B））和传统心血管（CV）危险因素相关。我们的目的是评估在何种程度上PE，调整传统的心血管危险因素，是独立与无症状的心脏异常postparty.Methods在这个横断面队列研究，107名前先兆子痫的妇女和41名妇女与平静的以往怀孕（对照）被邀请为心血管风险评估产后4-10年。这包括心脏超声、血压（BP）测量和代谢综合征决定因素的评估。根据美国心脏协会指南，无症状的结构和功能性心脏异常被归类为HF-B。高血压前期定义为收缩压120-139 mmHg和/或舒张压80-89 mmHg。单因素和多因素回归分析计算PE和传统危险因素与HF-B的相关性。结果PE组无症状HF-B的患病率约为对照组的3.5倍（25%vs7%，P < 0.01）; 67%的患者有向心性重构，22%的患者有轻度射血分数受损。调整产后间隔、高血压和高密度脂蛋白后，PE与HF-B显著相关（调整后比值比为4.4（95%CI，1.0-19.1））。此外，在以前的先兆子痫组，高血压前期与HF-B（比值比，4.3（95%CI，1.4-12.7））显着相关，而代谢综合征的决定因素是not.Conclusion PE是与一个四倍增加的女性特有的风险无症状的心脏异常。高血压前期明显增加这种风险显着，而代谢综合征的决定因素没有。版权所有（C）2016 ISUOG.出版社：John Wiley & Sons Ltd
Objectives Pre-eclampsia (PE) is associated with both postpartum structural asymptomatic heart disease (i.e. heart failure StageB (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 (C) 2016 ISUOG. Published by John Wiley & Sons Ltd.