Abnormal STE myocardial function prevalent in women with HELLP syndrome history

The rate of abnormal speckle-tracking echocardiography (STE) myocardial function is high during the first years following a pregnancy complicated by haemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome, regardless of whether there was concomitant pre-eclampsia (PE), reveals a study.

“Therefore, these women may benefit from cardiovascular (CV) risk management,” the authors said.

This cross-sectional retrospective study included women with a history of normotensive HELLP (n=32), PE without HELLP (n=59), and PE with HELLP (n=101) who underwent conventional and STE as part of the clinical CV work-up after their complicated pregnancies from 6 months to 4 years postpartum. However, women with comorbidities, such as chronic hypertension, hypercholesterolaemia, and obesity, were not included in the analysis.

Participants with a history of PE with HELLP syndrome were characterized by the following: a higher prevalence of altered left ventricular circumferential (74 percent) and global longitudinal two-dimensional (2D) strain (20 percent), altered right ventricular longitudinal 2D strain (37 percent), and left atrial 2D strain (57 percent). In addition, there was a higher proportion of alterations of biventricular and left atrial strains in former PE without HELLP syndrome and in the normotensive HELLP cohort.

“Pregnancy complicated by pre-eclampsia and HELLP syndrome is associated with an increased risk of CV diseases later in life. Subclinical cardiac alterations precede eminent CV diseases,” the authors said.

“STE is an effective method to assess subclinical myocardial dysfunction,” they added.