| Abstract [eng] |
Hypertensive disorders of pregnancy (HDP), including chronic hypertension, gestational hypertension, preeclampsia, eclampsia, and HELLP syndrome, are a major cause of maternal and fetal morbidity and mortality. These conditions are associated with increased risks of perinatal complications, preterm delivery, and long-term cardiovascular disease. Pregnancy is considered a physiological “stress test” that may reveal subclinical cardiovascular vulnerability; however, conventional markers do not always identify high-risk patients. This study aimed to evaluate inflammatory, echocardiographic, and vascular parameters in women with HDP and their association with delivery before 37 weeks. A cross-sectional study included 73 pregnant women (38 with HDP, 35 controls). Inflammatory biomarkers (IL-6, TNF-α), cardiac markers (troponin I, BNP), vascular parameters (pulse wave velocity, flow-mediated dilation), and advanced echocardiographic indices, including left atrial compliance and ventricular–arterial coupling, were assessed. Women with HDP exhibited increased inflammation, arterial stiffness, and subclinical systolic and diastolic dysfunction, along with reduced left atrial function. BNP and pulse wave velocity independently predicted delivery before 37 weeks. Left atrial compliance and ventricular–arterial coupling provided additional insight into early cardiovascular maladaptation. These findings highlight the value of integrated cardiovascular assessment in HDP and support its role in identifying an adverse maternal cardiovascular phenotype. |
