Cardiac Phenotypes of Pregnant Women with Hypertensive Disorders in Different Ethnic Groups

• Published in: International Journal of Biomedicine
• Main Authors: Bakhtykei M. Gasanova, Victor E. Radzinsky, Miroslava L. Polina, Natalya I. Douglas, Tatiana E. Burtseva, Praskovya N. Zakharova, Tatyana V. Dedy
• Format: Article in Journal/Newspaper
• Language: English
• Published: International Medical Research and Development Corporation 2022
• Subjects: chronic arterial hypertension; preeclampsia; left ventricular remodeling; inappropriate left ventricular mass; Medicine; R; Sakha; Evenks; Republic of Sakha; Yakutia; Yakuts
• Online Access: https://doi.org/10.21103/Article12(1)_OA4; https://doaj.org/article/d956a792bbc646bf865bfd35b256216e

The objective of this study was to conduct a comparative analysis of the features of LV myocardial remodeling in pregnant women with chronic arterial hypertension (CAH) and preeclampsia (PE) on the background of CAH. Methods and Results: The study cohort included pregnant women (n=547) with hypertensive disorders. All women were divided into two groups: Group 1 included 376 Caucasian patients living in the Republic of Dagestan; Group 2 included 171 patients living in the Republic of Sakha (Yakutia) (indigenous residents [Yakuts and Evenks). Later on, all patients were divided into the following subgroups: Sub1A (n=134), and Sub2A (n=69) – pregnant women with CAH; Sub1B (n=242) and Sub2B (n=102) – pregnant women with PE on the background of CAH. The diagnosis of pregnant women with CAH was made on the basis of existing national and foreign recommendations that an increase in SBP ≥140 mmHg and/or DBP ≥90 mmHg indicates CAH. Different patterns of left ventricular (LV) geometry were defined based on left ventricular mass index (LVMI) and relative wall thickness (RWT), as recommended by the American Society of Echocardiography. The observed/predicted LVM ratio was calculated as 100×(oLVM/pLVM). Participants with an oLVM/pLVM ratio of >128% were categorized as having “inappropriate” LVM (iLVM). iLVM was found in Subgroups 1B and 2B in the third trimester. The frequency of LV remodeling in pregnant women of Subgroups 1 A and 2A in the second and third trimesters did not differ significantly. In Subgroup 1B, the frequency of concentric left ventricular hypertrophy (cLVH) was higher in the third trimester (42.6%) than in the second trimester (26.9%) (P=0.000). Moreover, in the third trimester, the frequency of cLVH was significantly higher in Subgroup 1B than in Subgroup 2B (42.6% and 29.4%, respectively, P=0.022). At the same time, in the third trimester, the frequency of left ventricular concentric remodeling (LVCR) was significantly higher in Subgroup 2B than in Subgroup 1B (56.9% and 44.2%, respectively, P=0.032). ...