Prognostic Effect of Left Atrial Function by Three-Dimensional Speckle-Tracking Echocardiography on Adverse Pregnancy Outcomes in Patients With Hypertensive Disorders of Pregnancy: A Preliminary Study

IF 1.4 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques Pub Date : 2025-09-02 DOI:10.1111/echo.70287

Lan Tingyu, Zhang Meng, Zhang Huiqin, Lv Yifei, Zhou Yixi, He Wen, Du Lijuan, Zhang Wei

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引用次数: 0

Abstract

Objective

To evaluate the left atrial function in pregnant women with hypertension versus those with normotension using three-dimensional speckle tracking echocardiography (3D-STE) and investigate the association between left atrial dysfunction and adverse pregnancy outcomes.

Methods

A total of 94 pregnant women registered at the Tiantan Hospital between August 2023 and October 2024 who underwent comprehensive prenatal exams were enrolled. They were divided into three groups according to their blood pressure: gestational hypertension (GH), preeclampsia (PE), and normotensive control groups. The left atrial function was evaluated using two-dimensional speckle tracking echocardiography (2D-STE) and three-dimensional speckle tracking echocardiography (3D-STE). Demographic and echocardiographic parameters were analyzed and compared across the three groups. Maternal births were also documented. The primary adverse pregnancy outcomes included iatrogenic preterm delivery, admission to the neonatal intensive care unit, and infants with small for gestational age. The cohort of pregnant women with hypertensive disorders were stratified into two groups based on the occurrence of adverse pregnancy outcomes: those with adverse outcomes and those without. Comparative analyses were performed to evaluate the differences in demographic and echocardiographic parameters between these groups. Subsequently, regression analyses were performed to identify potential prognostic factors.

Results

Pregnant women with GH and PE exhibited increased maximum left atrial volume and decreased left atrial deformation during the reservoir (LASr) and conduit (LAScd) phases compared to those in the control group (p < 0.05). 3D-STE revealed significantly larger left atrial volumes in both the GH and PE groups (p < 0.05), and compared to the control group, the absolute value of LASr, LAScd, left atrial contractile strain (LASct), and the circumferential strain of the left atrial reservoir (LASrc) demonstrated a significant reduction in the GH and PE groups (p < 0.05). Multivariate logistic regression analysis determined the systolic blood pressure and LASr (3D-STE) as independent predictors of adverse pregnancy outcomes. The LASr (3D-STE) predictive cutoff was ≤27%.

Conclusion

3D-STE can detect early reduced left atrial function in patients with hypertensive disorders of pregnancy, and LASr can predict adverse pregnancy outcomes.

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三维斑点跟踪超声心动图左心房功能对妊娠期高血压疾病患者不良妊娠结局预后影响的初步研究

目的应用三维斑点跟踪超声心动图（3D-STE）评价高血压孕妇与血压正常孕妇的左房功能，探讨左房功能不全与妊娠不良结局的关系。方法选取2023年8月至2024年10月在天坛医院登记并进行全面产前检查的孕妇94例。根据她们的血压分为三组：妊娠期高血压（GH）组、先兆子痫（PE）组和正常血压对照组。采用二维散斑跟踪超声心动图（2D-STE）和三维散斑跟踪超声心动图（3D-STE）评价左房功能。对三组患者的人口学和超声心动图参数进行分析和比较。产妇分娩也有记录。主要不良妊娠结局包括医源性早产、入院新生儿重症监护病房和胎龄小的婴儿。高血压疾病孕妇队列根据不良妊娠结局的发生情况分为两组：有不良妊娠结局组和无不良妊娠结局组。通过比较分析来评估两组患者在人口学和超声心动图参数上的差异。随后，进行回归分析以确定潜在的预后因素。结果与对照组相比，GH和PE孕妇在储层期（LASr）和导管期（LAScd）左房最大容积增大，左房变形减小（p < 0.05）。3D-STE显示GH组和PE组左房容积均显著增大（p < 0.05），且GH组和PE组左房容积的LASr、LAScd、左房收缩应变（LASct）和左房储层周向应变（LASrc）的绝对值均较对照组显著降低（p < 0.05）。多因素logistic回归分析确定收缩压和LASr （3D-STE）是不良妊娠结局的独立预测因子。LASr （3D-STE）预测截止值≤27%。结论3D-STE可检测妊娠期高血压疾病患者早期左房功能下降，LASr可预测妊娠不良结局。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques 医学-心血管系统

CiteScore

2.40

自引率

6.70%

发文量

211

审稿时长

3-6 weeks

期刊介绍： Echocardiography: A Journal of Cardiovascular Ultrasound and Allied Techniques is the official publication of the International Society of Cardiovascular Ultrasound. Widely recognized for its comprehensive peer-reviewed articles, case studies, original research, and reviews by international authors. Echocardiography keeps its readership of echocardiographers, ultrasound specialists, and cardiologists well informed of the latest developments in the field.