Because the right ventricle "shortens" or contracts during heart contraction, researchers were able to see a 5 percent difference in the change of the heart's shape in those with severe preeclampsia compared with healthy controls.

The researchers also concluded that among the women with severe preeclampsia, the periods between contractions when the heart relaxes and fills with blood was also abnormal, decreasing the heart's ability to pump an adequate amount of blood to the body and overworking the heart when it did pump, leading to heart failure, according to Sammy Zakaria, M.D., M.P.H., assistant professor of medicine at the Johns Hopkins University School of Medicine.


Because of the abnormal relaxation rates in the hearts of women with severe preeclampsia, eight of the participants already had signs of heart failure and were classified as having grade II diastolic dysfunction.

In women with preeclampsia, the left atrium -- an upper chamber of the heart -- was about 3 centimeters squared larger than those in healthy women. This was yet another sign of heart enlargement and overwork, the researchers say. And the walls of the hearts in women with preeclampsia were on average 0.2 centimeters thicker than those of healthy women.

"A thicker, larger heart shows that the heart is working harder than normal," says Zakaria. "It gets bigger like the body's muscles when you work out, but in this case it isn't a good thing, and it's a serious risk factor for heart failure."

Six of the women with severe preeclampsia also had peripartum pulmonary edema, which, Zakaria says, is characterized by a fluid buildup in the lungs, causing swelling, difficulty breathing and other complications for both mother and fetus.

"The damage done to the heart's pumping ability during pregnancy in women with preeclampsia is striking, and it makes sense that this particular kind of damage puts them at greater risk of heart disease and strokes in the future," says Vaught.

The researchers do not at this point suggest that all pregnant women routinely undergo heart imaging, but say their study advances scientific understanding of the risks.

Long-known risk factors for preeclampsia include very young or relative old age when pregnant, being overweight, high blood pressure, family history of some autoimmune disorders such as lupus, and African or Hispanic descent.


Additional authors of the report include Linda Szymanski, Susan Mayer, Dhananjay Vaidya, Jamie Murphy, Cynthia Argani, Anna O'Kelly, Sara York, Pamela Ouyang and Monica Mukherjee of Johns Hopkins; Lara Kovell of the University of Massachusetts Medical School; and Sara Seifert of Brigham and Women's Hospital.

The study was funded by a Johns Hopkins Synergy Award and the Johns Hopkins Center for Child and Community Health Research's Biostatistics, Epidemiology and Data Management Core.

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