Observational studyBMC pregnancy and childbirth2025
Early cardiovascular changes in hypertensive pregnancies: insights from left atrial strain and compliance.
Observational study in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Incremental Value of Immediate Postpartum POCUS for Risk Stratification of Adverse Maternal Outcomes in Hypertensive Disorders of Pregnancy.Journal of clinical medicine · 2026Article
- Diagnostic Value of Two-Dimensional Speckle Tracking Echocardiography in Assessing Cardiac Function in Elderly Patients with Hypertensive Heart Disease.Clinical interventions in aging · 2025Article
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3 authors.
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Abstract
backgroundHypertensive disorders of pregnancy (HDP), which include gestational hypertension and preeclampsia, are associated with adverse maternal and fetal outcomes and may result in subclinical cardiac dysfunction. Traditional echocardiographic parameters, including the ejection fraction and Doppler indices, often fail to detect early myocardial and atrial abnormalities.
objectiveTo evaluate early cardiovascular changes in pregnant women with hypertensive disorders, with an explicit focus on left atrial (LA) strain and compliance assessed through speckle-tracking echocardiography.
methodsA prospective observational study was conducted at a tertiary care center, enrolling 73 pregnant women from 20 weeks of gestation onward: 38 with HDPs and 35 with normotensive pregnancies. Transthoracic echocardiography, including two-dimensional speckle tracking, was used to assess global longitudinal strain (GLS), LA strain (reservoir, conduit, contraction), and LA compliance (LASr/E/e'). Standard Doppler and tissue Doppler indices were also evaluated. Logistic regression was used to identify independent predictors of HDP.
resultsCompared with controls, women with HDPs presented significantly lower LA reservoir strain (31.00% vs. 35.00%, p = 0.002), conduit strain (18.00% vs. 24.00%, p < 0.001), and LA compliance (3.87 vs. 5.57, p < 0.001), despite having a preserved ejection fraction. GLS also decreased (19.00% vs. 21.00%, p < 0.001). In the multivariate analysis, decreased LA compliance (OR 0.50, 95% CI 0.33-0.76, p = 0.001) and GLS (OR 1.49, 95% CI 1.08-2.03, p = 0.014) were identified as independent predictors of HDP.
conclusionPregnant women with hypertensive disorders exhibit early subclinical cardiac dysfunction characterized by impaired left atrial (LA) strain and compliance. These advanced echocardiographic parameters may serve as sensitive markers for early cardiovascular changes, providing superior diagnostic value compared with conventional metrics. Routine evaluation of LA strain and compliance could improve risk stratification and guide management in hypertensive pregnancies.
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