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. 2021 Jan;41(1):95-102.
doi: 10.1111/cpf.12671. Epub 2020 Nov 6.

Increased arterial stiffness and reduced left ventricular long-axis function in patients recovered from peripartum cardiomyopathy

Magnus C Johansson  1   2 , Anders Barasa  2 , Carmen Basic  2 , Gunnar Nyberg  1   2 , Maria Schaufelberger  2
Affiliations

Increased arterial stiffness and reduced left ventricular long-axis function in patients recovered from peripartum cardiomyopathy

Magnus C Johansson et al. Clin Physiol Funct Imaging. 2021 Jan.

Abstract

Background: Peripartum cardiomyopathy (PPCM) is idiopathic pregnancy-associated heart failure (HF) with reduced left ventricular ejection fraction (LVEF). We aimed to assess arterial stiffness and left ventricular (LV) function in women recovered from PPCM compared with controls.

Methods: Twenty-two PPCM patients were compared with 15 age-matched controls with previous uncomplicated pregnancies. Eleven of the patients were at inclusion in the study recovered and off medication since at least 6 months and still free from cardiovascular symptoms with normal LVEF and normal NT-proBNP. All underwent echocardiography, including LV strain, left atrial (LA) reservoir strain and tissue Doppler early diastolic velocity (e´) and non-invasive assessment for arterial stiffness and central aortic systolic blood pressure (AoBP) at rest and immediately postexercise.

Results: The patients off medication showed alterations compared with controls. AoBP was higher (120 ± 9 mm Hg vs. 104 ± 13 mm Hg; p = .001), a difference which persisted postexercise. The arterial elastance was higher (1.9 ± 0.4 mm Hg/ml vs. 1.3 ± 0.2 mm Hg/ml; p < .001), while there were lower e´ septal (8.9 ± 1.7 cm/s vs. 11.0 ± 1.1 cm/s; p = 0. 002), LV global strain (18.7 ± 3.9% vs. 23.1 ± 1.6%; p = .004) and LA reservoir strain (24.8 ± 9.1% vs. 37.7 ± 6.3%; p = .002).

Conclusions: Compared with healthy controls, PPCM patients considered recovered and off medication had increased arterial stiffness, decreased LV longitudinal function and reduced LA function.

Keywords: arterial function; echocardiography; heart failure; preeclampsia; pregnancy.

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Conflict of interest statement

The authors have no conflict of interest.

Figures

FIGURE 1
FIGURE 1
The principle of the Arteriograph©. A pressure sensor in the BP‐cuff records the pressure fluctuations at 35 mm Hg above systolic pressure. Jug‐Sy is the distance between jugulum and symphysis, an estimate of aortic length (Horvath et al., 2010). By courtesy of Arteriograph/Tensiomed.com (Tensiomed, 2019)
See this image and copyright information in PMC

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