Diastolic function in middle-aged women with factors of unfavorable course and outcomes of pregnancy

Aim. To assess the parameters of left ventricular diastolic function in middle-aged women in association with unfavorable factors of pregnancy.

Material and methods. A total of 102 women aged 45-59 years with at least one completed pregnancy were examined. The patients underwent transthoracic echocardiography followed by interviewing to identify factors of unfavorable course and outcomes of pregnancy. The detection rate of factors of unfavorable pregnancy course and outcomes, differences in diastolic function parameters depending on specific factors of unfavorable course and outcomes of pregnancy, as well as the relationship of factors with diastolic dysfunction (DD) were assessed.

Results. The most pronounced changes in diastolic function quan­titative values were noted in relation to following hypertensive com­plications: septal peak mitral annular velocity (e’sept) was significantly lower in the group with hypertension (HTN) in pregnancy (7,3±1,5 vs 8,6±1,6 cm/sec, p=0,006); the ratio of peak transmitral flow velocity to mean mitral annular velocity (E/e’ mean) was significantly higher in the group with HTN in pregnancy — 9,1±2,4 vs 7,2±1,7 (p=0,006). Associations were found between DD and HTN (odds ratio (OR) =3,10 (95% confidence interval (CI): 1,19-8,01, p=0,02)), proteinuria (OR =4,69 (95% CI: 1,15-17,39, p=0,04)), smoking during pregnancy (OR =3,91 (95% CI: 1,16-12,89, p=0,03)).

Conclusion. The most pronounced changes in diastolic function parameters were noted in the group of women with hypertensive complications during pregnancy. The results of the study suggest an association between a number of factors of unfavorable pregnancy course and outcomes (hypertension, proteinuria, smoking) and DD.

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