286: Speckle tracking for cardiac strain is associated with preeclampsia severity

Preeclampsia is a risk factor for maternal cardiac dysfunction. We sought to examine clinical factors associated with echocardiographic evidence of cardiac dysfunction. Preeclamptic women aged 18-43 were recruited for this IRB approved study. Demographics, clinical data and outcomes were recorded during the ante and postpartum course. Bedside transthoracic echocardiography was performed for determination of myocardial function and myocardial strain with speckle tracking. Statistical analyses included t-test, Wilcoxon rank sum, and pairwise correlations. We enrolled 23 women with mild(n=10) and severe(n=13) preeclampsia. Echocardiography was available antepartum on 21(strain imaging on 8) and postpartum on 17(strain imaging on 11) women. Mean age was 28.7 ±5.6 years. Most women were Caucasian(n=21) and primigravida(n=14). Average gestational age at enrollment (32.0 ±4.8 weeks) was not significantly different between mild and severe preeclamptics. Speckle tracking on ante and postpartum echocardiography was not significantly different between those women with mild versus severe preeclampsia. Worsening strain (circumferential) on antepartum echocardiography was associated with earlier gestational age at diagnosis and delivery (p=0.05 and 0.03 respectively) as well as lower birth weight (p=0.03). Postpartum, worsening strain was associated with increasing mean arterial (MAP) and diastolic blood pressure on delivery date (p=0.01 and 0.01 respectively). Antepartum fractional shortening (FS) was lower in women with oligohydramnios (22.8 ±1.8 vs 28.3 ±4.5, p=0.04) and abnormal umbilical artery dopplers (24.6 ±3.1 vs 28.7 ±4.8, p=0.04). Postpartum, FS was lower in women with IUGR at admission (20.3 ±1.1 vs 33.3 ±8.3, p=0.03). Markers of preeclampsia severity including gestational age at diagnosis and delivery, MAP, oligohydramnios, abnormal umbilical artery dopplers, and fetal growth restriction may be predictors of cardiac risk given their association with echogradiographic cardiac dysfunction.