Assessment of Maternal Left Ventricular Dysfunction and Remodeling in Gestational Hypertension

Abstract

Background: The first trimester of pregnancy is where the mother's hemodynamic adaptation starts. A raise in preload, a drop in afterload, improved conduit vessel enforcement, ventricular remodeling, and a change in the renin system cause cardiac production to increase and diastolic activity to change. -the renin-angiotensinaldosterone axis. Aim: To assess maternal left ventricular dysfunction and remodeling in gestational hypertension. Methods: Our study was conducted on 50 patients divided on two groups as patients and control groups each of them 25. All subjects were evaluated by history taking, clinical examination, routine laboratory investigations, 12-lead ECG and echocardiography. Results: There was a statistically highly significant correlation between patients and control groups in age and parity with p values (0.027) and (0.023) respectively and significant correlation in left ventricular remodeling with p value for normal geometry and concentric LVH (<0.001) and (0.05) respectively. There was a significant correlation between patients and control groups with as regard left ventricular diastolic function in E/A ratio and septal E with P values <0.001 for both of them. There was a significant correlation between patients and control groups in using GLS with P value 0.001. Conclusion: As compared to normotensive deliveries, gestational hypertension is correlated with retained left ventricular systolic activity, subclinical diastolic dysfunction, and left ventricular remodeling in the context of increased mass and wall thickness, as well as a higher prevalence of concentric remodeling. Speckle monitoring echocardiography is important in the early identification of systolic dysfunction.