EVALUATION OF LEFT VENTRICULAR DIASTOLIC FUNCTION IN PREGNANCY INDUCED HYPERTENSION AND ITS COMPARISON WITH NORMOTENSIVE PREGNANT ASIAN INDIAN FEMALES

Introduction: Pregnancy related increased preload alters the diastolic properties of the left ventricle which have negative effects on maternal health. Scarcity of data exist on the diastolic properties of left ventricle in pregnancy induced hypertension. Objectives: To evaluate the Left ventricular diastolic dysfunction in pregnancy induced hypertension and its comparison with normotensive pregnant females using standard 2D echocardiography and Doppler studies. Methods: This is a prospective study done in Department of Cardiology, KLES Dr Prabhakar Kore Hospital,Belagavi,India. The study population consisted of 100 hypertensive(H) and 100 normotensive(N) pregnant females which were evaluated by 2D Echocardiography and Doppler parameters for diastolic dysfunction of Left ventricle. Diastolic parameters studied were mitral valve E wave, A wave, E/A ratio, isovolumetric relaxation time (IVRT), E deceleration time, Deceleration slope, pulmonary vein systolic (PVs), diastolic (PVd) and its ratio, E wave velocity time integral, A wave velocity time integral and tissue Doppler study of the mitral valve annulus. Results :Majority of the women in group N(94%) had normal diastolic function that is grade 0,compared to group H(56%). This difference was statistically significant (p < 0.001). Most significantly associated characteristics with diastolic dysfunction included MV: E/E? (p = 0.004), IVRT (p < 0.001), Deceleration Slope (p < 0.001),PVa(<0.001) and PVs(0.015). Mean grade of diastolic dysfunction in hypertensives was significantly high compared to normotensives (p<0.001). Conclusions: This study concludes that there is significant incidence of diastolic dysfunction in pregnancy induced hypertension as compared to normotensive Asian Indian females. LV inflow E/E`, Deceleration slope, IVRT and Pulmonary vein flow velocities are most significant echocardiographic characteristic associated with diastolic dysfunction in pregnancy induced hypertension.