The Role of Biomarkers and Imaging to Predict Preeclampsia and Subsequent Cardiovascular Dysfunction

Preeclampsia is a major cause of maternal morbidity and mortality worldwide. Despite decades of research, the ability of clinicians to accurately predict the onset of preeclampsia prior to the manifestation of symptoms has not significantly improved. In this review, we will examine the pathophysiology underlying preeclampsia and discuss the role of potential biomarkers for early prediction and diagnosis. In addition, we will explore imaging modalities in the detection of early myocardial and vascular endothelial dysfunction associated with preeclampsia. Circulating angiogenic and antiangiogenic biomarkers have emerged as key factors in the pathophysiology of the condition. However, single serological biomarkers have limited sensitivity to accurately predict preeclampsia; thus, a combination of clinical information along with urine or blood biomarkers is needed. The combined use of biomarker assays and new imaging modalities could enhance the predictive tools for this devastating disease and the development of cardiovascular sequelae. In the future, advances in proteomics, metabolomics, and other techniques may allow the identification of biomarkers with high enough predictive and prognostic information to be translated into clinical practice.