P 3 Relationship between maternal cardiac remodeling in preeclampsia and pregnancy outcome

Introduction It was well known that changes in cardiac geometry during pregnancy were more pronounced in pregnancy complicated by preeclampsia (PE). We were interested whether pregnancy outcome was more affected by changes in cardiac remodeling. Objectives The purpose of this study was to determine the relationship of changes in geometry of the left ventricle (LV) with the intrauterine growth restriction (IUGR) and preterm delivery in PE women. Methods Sixty hypertensive women with PE and 30 normotensive pregnant women without PE as controls, in the third trimester underwent a complete echocardiography that was used to assess parameters of chamber quantification and wall thickness. Relative wall thickness (RWT) was calculated as RWT = 2 x PWd/LVEDd. LV myocardial mass in grams was calculated by the Devereux formula and then was normalized for BSA as LV mass index – LVmass i (g/m 2 ). The LV remodeling was determined as normal geometry (NG), concentric hypertrophy (CH), eccentric hypertrophy (EH) and concentric remodeling (CR) according to the reference values of RWT and LVmass index due to recommendations of Europian Association of Cardiovascular Imaging and American Society of Echocardiography. Results There werent statistically significant differences between groups in the following parameters: age, heart rate, height, weight. PE women had statistically significant higher values in almost parameters of the LV geometry, that caused most abnormal geometry in women with PE. Most controls had NG, while CH was most presented in PE 31,7% vs 3.3% in controls ( p p i was significant higher in IUGR group ( p  = 0.044) and in women with preterm delivery ( p  = 0,014). Univariate regression analysis revealed that LVmass i had significant influence on IUGR ( p  = 0.05; OR 1,052; 95% CI 1–1,108), also as on preterm delivery ( p  = 0.021; OR 1,072; 95% CI 1,011–1,137). Conclusion Pregnancy outcome in preeclampsia was statistically significant associated with changes in cardiac remodeling, particularly LVmass i .