Banca de QUALIFICAÇÃO: RICARDO LUIZ DE MEDEIROS LIMA

Uma banca de QUALIFICAÇÃO de DOUTORADO foi cadastrada pelo programa.
STUDENT : RICARDO LUIZ DE MEDEIROS LIMA
DATE: 30/05/2022
TIME: 14:30
LOCAL: DEFESA REMOTA - https://meet.google.com/yvj-nrcs-rpt
TITLE:

Two-dimensional echocardiography can detect early ventricular dysfunction in Hypertensive disorders of pregnancy

KEY WORDS:

Hypertensive disorders of pregnancy, preeclampsia, ventricular dysfunction and echocardiography

PAGES: 32
BIG AREA: Ciências da Saúde
AREA: Medicina
SUMMARY:

Background. Hypertensive disorders of pregnancy (HDP) include gestational arterial hypertension, chronic hypertension overlapping preeclampsia and preeclampsia. Women with previous history of preeclampsia have an increased risk of early onset of cardiovascular disease. Transthoracic echocardiography is a tool to determine the performance of the cardiac muscle and assess ventricular function.

Objectives. The aim of the study was to use transthoracic echocardiography to assess myocardial function in pregnancy and whether hypertensive disorder of pregnancy may alter ventricular function.

Study design. A prospective study was performed with pregnant women after the 12th week of gestation at the first prenatal visit. 123 were recruited and data collected included clinical history, weight, height, age, left ventricular systolic function with global longitudinal strain (GLS), blood pressure, and pregnancy related data (number of gestations, age of gestation and history of miscarriage). A correlation matrix and univariate analysis of the studied variables followed by canonic analysis were performed.

Results. Of 123 women recruited, 87 were followed until the end of the pregnancy. The age of the participants was between 16 and 38 years (28.12±6.35) and 61 (70.1%) had high body mass index (BMI>25kg/m2), with 36 (41.4%) classified as overweight, 23 (26.4%) with grade I or II obesity (BMI from 25 to 29.9kg/m2) and 2 (2.3%) with grade III obesity (BMI>39.9kg/m2). Forty-one of the participants (47.1%) were primigravida. Hypertrophy or myocardial remodeling was present in 12 (13.79%). Ejection fraction was less than 50% in 4 (4.6%) and the GLS less than 18% in 6 (6.9%) participants. There was no significant correlation between ventricular function and any echocardiographic, anthropometric, gestational or clinical parameters. However, canonical analysis showed correlation between anthropometric parameters (BMI, height and weight) and diastolic function (ρ=0.65, p-value<0.001), presence of hypertension and diastolic function (ρ=0.64, p-value<0.001), anthropometric parameters and hypertension (ρ=0.57, p-value<0.001), hypertension and systolic function (ρ=0.57, p-value<0.001), anthropometric parameters and systolic function (ρ=0.49, p-value=0.002) and anthropometric parameters and gestational parameters (ρ=0.43, p-value=0.003). Univariate analysis also showed differences between hypertensive parameters when compared the earlier and the last exam performed in the same woman.

Conclusions. Transthoracic echocardiography with global longitudinal strain is useful during prenatal care to evaluate left ventricular function allowing early intervention.

BANKING MEMBERS:
Externa ao Programa - 1149381 - ANA CRISTINA PINHEIRO FERNANDES DE ARAUJO
Externa ao Programa - 2495713 - ROSIANE VIANA ZUZA DINIZ
Presidente - 350647 - SELMA MARIA BEZERRA JERONIMO