Left ventricular function impairment in pregnancy-induced hypertension

The changes induced by transient hypertension on cardiac structure and func tion are unclear. Pregnancy-induced hypertension offers a natural and spont aneous model of this condition. To assess the potential of echocardiographi c Doppler to unmask left ventricular function impairment, we studied 28 wom en aged 26.4 +/- 7.2. years with pregnancy-induced hypertension defined as blood pressure higher than 130/90 mm Hg in the third trimester of pregnancy without a history of hypertension. Twenty normal pregnant women, aged 27.5 +/- 6.4 years, were the controls. Left ventricular diastolic diameter, fra ctional shortening, E velocity, A velocity, E/A ratio, isovolumetric relaxa tion time (IRT), isovolumetric contraction time (ICT), ejection time (ET), and the combined index of myocardial performance (Tei index = IRT + ICT/ET) , were calculated by echocardiography Doppler 2 to 4 days postpartum. There were statistically significant differences between groups in the following parameters: E/A ratio: 1.3 +/- 0.3 in preg nancy-induced hypertension v 1. 5 +/- 0.3 in normal pregnant women (P < .05). IRT: 104 +/- 14 msec v 84 +/- 7 msec (P < .000), and the Tei index: 0.51 +/- 0.15 v 0.35 +/- 0.04 (P < . 00), respectively. According to this data pregnancy-induced hypertension ev aluated 2 to 4 days after delivery showed left ventricular dysfunction, mai nly diastolic. The IRT and the Tei index are the most useful echocardiograp hic parameters to unmask left ventricular dysfunction in pregnancy-induced hypertension. (C) 2001 American Journal of Hypertension, Ltd.