Affiliation:
1. Department of Obstetrics and Gynecology University of Chicago IL
2. Department of Anesthesia and Critical Care University of Chicago IL
3. Department of Anesthesia Critical Care and Pain Medicine Massachusetts General HospitalHarvard Medical School Boston MA
4. Department of Medicine University of Chicago IL
5. Department of Physiology and Biophysics University of Mississippi Medical Center Jackson MS
Abstract
Background
Preeclampsia is a prominent risk factor for long‐term development of cardiovascular disease. Although existing studies report a strong correlation between preeclampsia and heart failure, the underlying mechanisms are poorly understood. One possibility is the glycoprotein growth factor activin A. During pregnancy, elevated activin A levels are associated with impaired cardiac global longitudinal strain at 1 year, but whether these changes persist beyond 1 year is not known. We hypothesized that activin A levels would remain increased more than 1 year after a preeclamptic pregnancy and correlate with impaired cardiac function.
Methods and Results
To test our hypothesis, we performed echocardiograms and measured activin A levels in women approximately 10 years after an uncomplicated pregnancy (n=25) or a pregnancy complicated by preeclampsia (n=21). Compared with women with a previously normal pregnancy, women with preeclampsia had worse global longitudinal strain (−18.3% versus −21.3%,
P
=0.001), left ventricular posterior wall thickness (0.91 mm versus 0.80 mm,
P
=0.003), and interventricular septal thickness (0.96 mm versus 0.81 mm,
P
=0.0002). Women with preeclampsia also had higher levels of activin A (0.52 versus 0.37 ng/mL,
P
=0.02) and activin/follistatin‐like 3 ratio (0.03 versus 0.02,
P
=0.04). In a multivariable model, the relationship between activin A levels and worsening global longitudinal strain persisted after adjusting for age at enrollment, mean arterial pressure, race, and body mass index (
P
=0.003).
Conclusions
Our findings suggest that both activin A levels and global longitudinal strain are elevated 10 years after a pregnancy complicated by preeclampsia. Future studies are needed to better understand the relationship between preeclampsia, activin A, and long‐term cardiac function.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine
Cited by
27 articles.
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