Assessment of right heart function in preeclampsia by echocardiography

Background: Preeclampsia (PE) is a multisystemic disorder characterized by hypertension and proteinuria that is specific to pregnancy and associated with maternal and fetal morbidity-mortality. Aim: To assess right heart structure and function in PE by echocardiography using conventional and tissue Doppler techniques. Methods: In total, 67 women with untreated PE and 46 matched healthy pregnant women were included. PE was defined according to the ACOG (2002) criteria. Right and left heart functions were evaluated using transthoracic two-dimensional (2D) echocardiography with color Doppler and tissue Doppler imaging techniques. Results: Right ventricular basal and outflow tract diameters and free wall thickness, right atrial end systolic maximum diameter, and area were significantly higher in the PE group than the control group (p < 0.05). Tricuspid annular plane systolic excursion, isovolumic acceleration time, tissue Doppler derived tricuspid lateral annular systolic velocity (S'), right ventricle fractional area change, and myocardial performance index (Tei) were significantly lower in the PE group than the controls (p < 0.05). Conclusions: PE does not only affect the left side of the heart but also the right side. This finding may open new scenarios, because right ventricular dysfunction may also be responsible for PE-related morbidity. (C) 2016 Published by Elsevier B.V. on behalf of International Society for the Study of Hypertension in Pregnancy.