ABSTRACT 

Objective: Pre-eclampsia is associated with maternal cardiac remodelling and diastolic dysfunction. The aim of this study was to assess and compare maternal left ventricular structure and diastolic function and Brain Natriuretic Peptide (BNP) levels in women with early-onset pre-eclampsia (<34 weeks of gestation) and late-onset pre-eclampsia (≥34weeks of gestation).  

Methods: A prospective, cross-sectional observational study was performed in 30 women with early-onset pre-eclampsia, 32 with late-onset pre-eclampsia and 23 normotensive controls. Maternal cardiac structure and diastolic function as assessed by echocardiography and plasma levels of BNP were measured by enzyme immunoassay.

Results: Pre-eclampsia was associated with an increased left ventricular mass index and relative wall thickness in early-onset pre-eclampsia compared with late-onset pre-eclampsia and normotensive controls. The prevalence of concentric hypertrophy (40%) and diastolic dysfunction (23%) was also significantly higher in early-onset pre-eclampsia than in late-onset pre-eclampsia (16% for both, all p<0.05). Maternal serum BNP values were also significantly higher in early-onset pre-eclampsia (p<0.05) and correlated with relative wall thickness and left ventricular mass index.  

Conclusions: Early-onset pre-eclampsia has more severe cardiac impairment than late-onset pre-eclampsia as evidenced by increased prevalence of concentric hypertrophy, diastolic dysfunction and high concentrations BNP. These findings suggest that early-onset pre-eclampsia causes greater myocardial damage increasing the risk of both peripartum and postpartum cardiovascular morbidity. Although these cardiovascular effects are easily identified by echocardiographic parameters and measuring BNP, further studies are needed to assess their clinical utility.