Pregnant women with hypertensive disorders of pregnancy show significantly reduced heart muscle function compared with healthy controls, according to new research.
A retrospective study of 175 women found that patients with hypertensive disorders of pregnancy (HDP) had a mean global longitudinal strain of -17%, compared with -20% in healthy pregnant controls and -21% in non-pregnant controls. The findings indicate subclinical systolic dysfunction.
"Emerging evidence shows that HDP not only impact maternal health during pregnancy but also increase lifetime cardiovascular risk," reported Evan Klein, MD, and colleagues, from Rush University Medical Center in Chicago.
Their research was chosen as a 2025 Arthur E. Weyman Young Investigator’s Award Competition Finalist, presented at the American Society of Echocardiography (ASE) 2025 annual meeting, and as an abstract in the Journal of the American Society of Echocardiography.
Their study analyzed 74 patients with 1 or more hypertensive disorders of pregnancy, 51 healthy pregnant controls, and 50 healthy non-pregnant controls using two-dimensional speckle tracking echocardiography to measure GLS.
Hypertensive disorders of pregnancy represent the leading causes of maternal morbidity and mortality worldwide and increase lifetime cardiovascular risk beyond the pregnancy period. Currently, the role of transthoracic echocardiography in addressing HDP has not been well-established, despite emerging evidence of long-term cardiac implications.
Investigators used the nearest transthoracic echocardiography study to delivery date for each patient. Although the study groups differed in transthoracic echocardiography (TTE) timing relative to delivery, smoking status, and prevalence of non-gestational diabetes, multivariable regression indicated these factors were not independently associated with reduced GLS.
Methodology was validated through inter-observer reliability testing, with 24 patients undergoing global longitudinal strain analysis by 3 echocardiographers. The Cronbach alpha coefficient of 0.78 indicated sufficient internal validity for the strain measurements.
GLS is an advanced echocardiographic technique that tracks speckle patterns to quantify myocardial deformation and can reveal subclinical systolic dysfunction not apparent on conventional measures. The authors noted that earlier detection may enable better risk stratification and treatment for patients with HDP.
“Our study demonstrates that HDP are associated with significantly reduced GLS compared to healthy pregnant and non-pregnant controls. Therefore, TTE with strain analysis should be routinely considered in pregnant women to screen for subclinical myocardial dysfunction and development of HDP,” they noted.
Disclosures were not available at press time.