Abstract 493: Serum Leptin and TNFa Levels in Relation to Systolic and Diastolic Heart Function in Obese and Normal-overweight Pregnant. First Trimester Data

Introduction: Maternal obesity (MO) defined as pre-pregnancy body-mass index (BMI) >30kg/m2, is the strongest risk factors for preeclampsia (PE). Information regarding cardiac changes in MO as well as the role of inflammatory biomarkers in PE pathogenesis is conflicting. The aim of this study was to evaluate echocardiography changes in normal/ overweight pregnant (NP) (BMI 18.0-30) and obese pregnant women (OP) (BMI>30) and to correlate them to dynamics of biomarkers (leptin, TNFa, BNP, pentraxin-3, IL6) and mRNA. Material and methods: There were 11 OP (BMI 33.6±2.9) and 13 NP (BMI 25.5±2.3) enrolled into this study in the first trimester of pregnancy. All patients were nulliparous. There were no differences between OP and NP according to age and number of previous pregnancies. Patients with pre-pregnancy cardiovascular pathology were excluded. The 2D echocardiography with Doppler was performed in each pregnancy trimester. Echocardiography results, leptin and TNFa in the first trimester are available for now. Results: Left ventricular (LV) mass was significantly higher while ejection fraction (EF) and ratio of the early (E) to late (A) ventricular filling velocities (E/A ratio) appeared to be lower in OP, compared to NP (Table). Leptin was higher in OP. TNFa inversely correlated with stroke volume (SV), MO positively associated with leptin levels and negatively with E/A ratio (p<0.05). Conclusion: Differences in systolic and diastolic heart function between OP and NW are being evident already in the first trimester. Involvement of leptin and TNFa; might be suggested. Identifying biochemical mechanisms driving cardiac changes in MO are crucial for PE prevention.