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ABSTRACT
| Differential Left Ventricular Remodeling in Hypertensive Disorders of Pregnancy Subtypes Among Sub-Saharan African Populations |
| Abdulaziz Aminu1*, Simeon A. Isezuo1, Hayatu Umar1, Usman M. Zagga1, Abubakar A. Panti2, Sanusi Garba3, Adamu Muhammad1, Fahad Lawal1, Ahmad A. Usman1, Bello A. Magaji4, Jamila A. Garba2 |
| Background: Hypertensive disorders of pregnancy (HDP) are major global causes of maternal and fetal morbidity and mortality, particularly in developing countries like Nigeria. The spectrum of pregnancy-related hypertension encompasses preeclampsia, pregnancy-induced hypertension, chronic hypertension in pregnancy, and preeclampsia superimposed on chronic hypertension. While structural and functional cardiac changes in chronic hypertension are well-documented, data on the specific spectrum of left ventricular geometry in HDP remain limited. Aims: This study aimed to assess left ventricular geometry in women with hypertensive disorders of pregnancy. Methodology: This was a cross-sectional study. One hundred and forty pregnant women meeting the diagnostic criteria for HDP were recruited, with an equal number of normotensive pregnant women serving as controls. Echocardiography was performed on all participants. Left ventricular (LV) geometry was determined from the left ventricular mass index (LVMI) and relative wall thickness (RWT). LV geometry was categorized as: normal (LVMI ≤95 g/m2 and RWT ≤0.42), concentric remodelling (CR) (LVMI ≤95 g/m2 and RWT >0.42), eccentric hypertrophy (EH) (LVMI >95 g/m2 and RWT ≤0.42), and concentric hypertrophy (CH) (LVMI >95 g/m2 and RWT >0.42). Results: Among the 140 women with HDP, 55 (39.3%) had pregnancy-induced hypertension, 45 (32.1%) had preeclampsia-eclampsia, 20 (14.3%) had chronic hypertension with superimposed preeclampsia, and 20 (14.3%) had chronic hypertension in pregnancy. The proportion of women exhibiting abnormal Geometry was significantly higher in the HDP group (65.7%) compared to the NP group (14.3%; p < 0.001). The predominant abnormal LV geometric pattern in HDP patients with preexisting chronic hypertension was concentric LV hypertrophy (62.5%), whereas concentric remodelling was the most common abnormal LV geometry in those without preexisting chronic hypertension (29%). Conclusion: This study highlighted that HDP is significantly associated with abnormal LV geometry, a critical determinant of future cardiovascular risk. The distinct LV remodelling patterns observed underscore the need for comprehensive cardiac assessment in HDP to guide clinical interventions, facilitate further research, and inform public health strategies for improving long-term cardiovascular health in affected women. |
| 10.51658/ABMS.202561.3 |
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