La preeclampsia es precedida por alteración de la función cardiovascular;
Preeclampsia is Preceded by Cardiovascular Function Abnormalities

Introducción: La preeclampsia (PE) se acompaña de cambios en la función cardiovascular (FCV). Sin embargo, es desconocido si los cambios preceden y persisten a la manifestación clínica de PE. Objetivos: Evaluar las diferencias en la FCV, en la semana 22 de gestación (22sg) y un año posterior al parto (1app) en las pacientes que evolucionaron a la PE vs. a la normotensión (N). También, la asociación entre la FCV en 22sg y la evolución a PE. Material y métodos: Estudio prospectivo, que incluyó 260 primíparas normotensas. Se midió en la semana 22sg y a 1app: laboratorio de rutina, proteinuria de 24horas, presión arterial (PA). Por cardiografía por impedancia: índice cardíaco (IC) y de resistencia vascular sistémica (IRVS), velocidad de onda de pulso (VOP). Se formaron 3 grupos según la evolución a: PE, G1, HTA gestacional (HG) G2, y N, G3. Los resultados se presentan como media ± DS, ANOVA y test post hoc, p < 0,05. Resultados: 12 pacientes evolucionaron a PE, 18 a HG y 220 a N. El G1 presentó en los dos tiempos de medición, valores inferiores de IC y superiores de PA, IRP y VOP comparados al G3. El G2 presentó valores intermedios entre el G1 y el G3. La VOP y el IRP en la S22g de gestación resultaron predictores de PE. Conclusiones: Las pacientes que evolucionaron a PE presentaron en fase temprana del embarazo diferente FCV respecto a las normotensas. El diagnóstico temprano de estos cambios contribuiría a predecir la PE y prevenir sus complicaciones.

Background: Preeclampsia (PE) is associated with changes in cardiovascular function (CVF), but whether these changes precedeand persist in the clinical phase of the disease is still unknown.Objectives: The aim of this study was to evaluate the differences in CVF at 22 weeks of pregnancy and one year after delivery inpatients who developed PE vs. those with normotension (N). The association between CVF at 22 weeks of pregnancy and the developmentof PE was also analyzed.Methods: A prospective study was conducted including 260 normotensive primiparous women. Routine laboratory tests, 24-hoururine protein and blood pressure (BP) were measured at 22 weeks and one year after delivery. Cardiac index (CI), systemic vascularresistance index (SVRI), and pulse wave velocity (PWV) were measured by impedance cardiography. The population was divided intothree groups according to the outcome during pregnancy: G1: PE, G2: gestational hypertension (GH) and G3: N. The results arepresented as mean ± SD, ANOVA and post hoc test, p <0.05.Results: Twelve patients evolved to PE, 18 to GH and 220 remained with N. In G1, CI was lower and BP, SVRI and PWV were higherthan in G3 at 22 weeks of pregnancy and one year after delivery. In G2, values were always intermediate between G1 and G3. PWVand SVRI measured at 22 weeks of pregnancy resulted predictors of PE.Conclusions: Patients who developed PE had different CVF in the early stage of pregnancy than those with normotension. The earlydiagnosis of those changes could predict PE and thus contribute to prevent its complications.