The Effect Of Myocardial Function In Offspring After Pregnancy Complicated By Preeclampsia

Objective:Conventional two-dimensional echocardiography and two-dimensional speckle tracking techniques were used to evaluate general parameters of cardiac function,myocardial strain and torsion function in children(age 5-8 years)delivered by pregnancy complicating severe preeclampsia and those who were normal to investigate the effect of severe preeclampsia on the cardiac function of the offspring.Methods:Subject:Recruitment of children delivered by women with severe preeclampsia or without complications from 2010 to 2012 in the First Affiliated Hospital of Soochow University.Exclusion criteria included maternal diabetes during pregnancy,hematological diseases,immune system diseases,malignancy,heart diseases,fetal congenital heart diseases or other malformations,fetal intrauterine infections,etc.The gestational age?37weeks was the term group,and 28 weeks?gestational week<37 weeks was the preterm group.The fetuses whose birth weight below the 10 th percentile of the same age fetus defined as the FGR(fetal growth restriction,FGR)group,and the non-FGR group were normally grown fetuses with birth weight above the 10 th percentile.Cardiac ultrasonography:One chief physician of cardiac ultrasound performed all echocardiographic examinations by a Vivid E9 scanner(GE Vingmed,Horten,Norway)with a standard phased array multi-frequency transducer(5S probe,2-4 MHz).The children were awake,relaxing in a left semi-lateral supine position.Two-dimensional(2D)and color-coded conventional transthoracic echocardiographic evaluations were performed at the standard precordial position to measure cardiac routine parameters and to Simultaneously acquire two-dimensional grayscale dynamic images of the apical left ventricle long-axis and short-axis,four-chamber views and two-chamber views.speckle tracking imaging software was used to obtain data of left ventricular longitudinal strain,circumferential strain,radial strain,left ventricular twist,right ventricular longitudinal strain.Data analysis:All data were analyzed by using spass 19.0 statistical software.The T-test of independent samples is administered in data with the normal distribution,while the rank-sum test is applied in those not consistent with the normal distribution.The results were described as mean±SD,or median(interquartile range).P<0.05 was considered statistically significant.Results:1.In terms of growth and development,the height(116 vs 124 cm),weight(20.9 vs24.4 kg),body mass index(18.0 vs 19.6 kg/m~2),and body surface area(0.81 vs 0.92 m~2)of preterm children delivered from women complicated by severe preeclampsia were lower than those of preterm children in the normal control group(P<0.05);Term children delivered from women complicated by severe preeclampsia had only height(115 vs 124cm)and body surface area(0.82 vs 0.94 m~2)lower than those of term children in the normal control group(P<0.05).The height(115 vs 124 cm),weight(20.6 vs 24.8 kg),body surface area(0.80 vs 0.93 m~2)of FGR children delivered by women with severe preeclampsia were lower than non-FGR children in the control group(P<0.05).2.In terms of cardiac structure,there were no significant differences in the ventricular outflow tract inner diameter,left ventricular inner diameter,standardized left ventricular volume,left atrium volume index,right atrium volume index,aortic root diameter,left ventricular septal thickness between the severe-preeclampsia group and the normal control group(P>0.05).When compared with non-FGR children in the control group,the severe-preeclampsia FGR group had decreased left ventricular end-diastolic diameter(35.3vs 37.0 mm),aortic root diameter(19.2 vs 20.3 mm),and left ventricular diastolic thickness(5.6 vs 5.8 mm)(P<0.05).3.In terms of conventional systolic function,there were no significant difference in left ventricular stroke volume,left ventricular cardiac output,left ventricular shortening fraction,left ventricular ejection fraction,right ventricular area change score between the severe-preeclampsia group(include preterm birth and term birth)and the corresponding control group(P>0.05).However,the stroke volume of FGR children with severe preeclampsia(19.29 vs 23.21 ml)was lower than non-FGR children in the normal control group(P<0.05).4.In terms of conventional diastolic function,no significant differences were found in mitral valve E peak,mitral valve A peak,mitral valve E/A value,and pulmonary vein spectrum between severe-preeclampsia groups and the corresponding control groups(P>0.05).5.Preterm delivered children in the severe preeclampsia group had higher heart rate(93 vs 84bpm)than those in the normal preterm control group(P<0.05).FGR children in severe preeclampsia group had faster heart rate(91 vs 85bpm)than non-FGR children in the normal control group(P<0.05).6.There were no differences in left ventricular longitudinal strain,left ventricular circumferential strain,left ventricular radial strain,right ventricular longitudinal strain between severe preeclampsia groups and their corresponding control group(P>0.05).7.No differences were found between severe preeclamptic groups and their corresponding control groups in myocardial performance index,left ventricular torsion(P>0.05).Conclusions:1.Severe preeclampsia had no significant effect on the conventional systolic and diastolic function of the offspring's heart,myocardial strain,myocardial performance index,and left ventricular torsion at 5-8 years of age.2.Severe preeclampsia had affected children's growth and development,and it had a greater impact on children when combined with preterm birth or FGR.3.FGR children delivered from severe preeclampsia had limited heart development,resulting in a smaller left ventricular cavity,thinner ventricular septal wall,lower left ventricle stroke volume,and increased heart rate,but the cardiac output remained unchanged.