Preeclampsia is a specific maternal complication of pregnancy and leads to increased cardiovascular morbidity. Fortunately, early diagnosis and care of cardiac injury improves pregnant woman's prognosis. Speckle-tracking imaging (STI) has been shown to be a sensitive tool for detecting early changes in heart function even before other means conventionally used for the assessment of ventricular function.
The contribution of STI in the early diagnosis of myocardial injury during preeclampsia.
This was a prospective, descriptive and comparative study performed on 30 pregnant women diagnosed with preeclampsia between January and July 2019. This group was compared to a control group of 30 healthy pregnant women. The duration of follow-up was 3 months. The women included were between 18 and 42 years of age with a term of pregnancy between 28 and 38 weeks of gestation. They met the ACOG definition of preeclampsia and had no pre-existing cardiac, pulmonary, renal pathology, any severe anemia or concomitant infection. All transthoracic echocardiograms (TTE) were performed by the same cardiologist.
The mean age and the mean term of the TTE were comparable without significant difference (29.4±5.96, P=0.11 and 34.4 vs. 34.8, P=0.38). There was a significant difference in the values of the longitudinal strain (LS) on the 3 chamber view (−17.1% vs. −19.7%; P=0.001) but not on the 4 chamber view (−18% vs. −19, 8%; P=0.007) nor on the 2 chamber view (−17.6% vs. −19.6%; P=0.006). But the global LS and the right ventricular LS were significantly lowered compared to the control group (−21.7±2% vs. −17.73±3%; P=0.003, −16.9% vs. −20.1%; P<0.001).
SPI, thus, allows early diagnosis of cardiac complications of preeclampsia making it a sensitive mean of early ventricular dysfunction screening even in pregnant women.Le texte complet de cet article est disponible en PDF.