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1 Department of Medicine, University of Sydney, Sydney, New South Wales 2006; and Departments of 2 Cardiology and 3 Renal Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales 2050, Australia
Increased cardiac output in pregnancy is
associated with cardiac remodeling and possible reduction in
contractility, which may worsen in preeclampsia. Left ventricular (LV)
geometry and function were compared between nonpregnant controls
(n = 12) and normotensive (n = 44) and
preeclamptic (n = 15) pregnant women using
echocardiography. Load-independent comparisons of LV systolic function
compared end-systolic stress (ESS) and rate-corrected velocity of
circumferential fiber shortening (VCFC). Mean
arterial pressures were 101 ± 14 mmHg in preeclampsia, 76 ± 6 mmHg in normotensive pregnancy, and 78 ± 6 mmHg in controls
(P < 0.005 vs. preeclampsia). LV mass increased during
normotensive pregnancy (66 ± 13 to 76 ± 16 g/m2; P < 0.05; controls, 65 ± 10 g/m2; P < 0.05) and was greater in
preeclampsia (90 ± 18 g/m2; P < 0.05). In normotensive pregnancy, ESS decreased (59 ± 9 to
52 ± 11 g/cm2; P < 0.05; controls,
66 ± 14 g/cm2; P < 0.005). ESS was
greater in preeclampsia (60 ± 14 g/cm2;
P < 0.05). In controls, there was an inverse
relationship between ESS and VCFC
(r = 
0.78). The ESS-VCFC
relationships in normotensive and preeclamptic pregnancy were unchanged
from controls. We conclude that LV hypertrophy in normotensive and
preeclamptic pregnancy matches changes in cardiac work, and LV
contractility is preserved.
preeclampsia; echocardiography; ventricular function; myocardial contractility; hypertension
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