ArticleAmerican journal of translational research2026
Postpartum cardiac complications after hypertensive disorders of pregnancy: predictive roles of retinal arteriolar-to-venular ratio and NT-proBNP.
Article in American journal of translational research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo investigate whether retinal arteriolar-to-venular ratio (AVR) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) assessed at 42 days postpartum can predict cardiac complications within 6 months in women with hypertensive disorders of pregnancy (HDP), and to evaluate whether NT-proBNP mediates the association between AVR and cardiac complications.
methodsThis retrospective cohort study enrolled 386 women with HDP and 105 normotensive controls between March 2021 and March 2024. At 42 days postpartum, participants underwent cardiac assessment (NT-proBNP, echocardiography) and retinal microvascular measurement (central retinal arteriolar equivalent, central retinal venular equivalent, AVR). Cardiac complications were defined as heart failure or persistent/recurrent hypertension within 6 months postpartum. Logistic regression, receiver operating characteristic (ROC) curve analysis, and mediation analysis were performed.
resultsCompared with controls, women with HDP showed higher NT-proBNP, larger left ventricular end-diastolic diameter, and lower AVR (all P<0.05). These parameters worsened progressively with HDP severity. During follow-up, 97 women (25.1%) developed cardiac complications. Elevated NT-proBNP and reduced AVR were independent predictors of complications. The combined model achieved greater AUC than AVR alone. Mediation analysis indicated NT-proBNP partially mediated the AVR-complication relationship.
conclusionsWomen with HDP exhibit early postpartum cardiac dysfunction and retinal microvascular impairment. Lower AVR, partly mediated through NT-proBNP, may help identify those at higher risk of cardiac complications.
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