98 Evolution of cardiac remodeling associated with pregnancy in hypertensive women six months postpartum

Introduction Systemic arterial hypertension (SAH) is one of the principal risk factors for developing cardiovascular disease. When a hypertensive woman becomes pregnant, a new hemodynamic condition is installed, with transition from chronic pressure overload to chronic volume overload. This new hemodynamic condition can cause greater myocardial hypertrophy (LVH), whose postpartum evolution has been little studied in the literature. It is suspected that hypertensive women who presented LVH during pregnancy maintain this cardiac alteration, six months after delivery. Objectives to evaluate myocardial mass in hypertensive women in the third trimester of pregnancy and six months after delivery. Methods prospective longitudinal study including 30 pregnant women beyond 35 gestational weeks and with previous SAH diagnosis, monitored at the Obstetrics Unit of the Botucatu School of Medicine – Unesp. They were submitted to clinical and echocardiographic evaluation at two moments, the gestational period and six months postpartum. LVH was defined for the left ventricular mass index as (LVMI) u003e45 g/m 2,7. Statistical analysis The echocardiographic variables were compared between moments by the non-parametric test of Wilcoxon and simple linear regression models adjusted for each moment of evaluation. Significance level: p Results The median age was 29 years, the time of SAH diagnosis varied from 5 to 132 months; the majority of the women were white (83.3%) and 18 (60%) women were treated with antihypertensive medications during pregnancy. At the end of pregnancy, all except two of the women presented HVE. Six months postpartum, only four women did not present HVE. Elevated frequency of obesity and lack of ideal control of pressure levels were observed. There was a significant positive correlation between body mass index (BMI) and LVMI at the end of gestation ( p  = 0.001) and six months after delivery ( p  = 0.001). Conclusions In pregnant hypertensive women, the LVH frequency is elevated at the end of pregnancy, and the recovery frequency of this hypertrophy, at the six-month follow-up after delivery, is very low. These results justify long-term follow-up with a cardiologist since persistent myocardial hypertrophy imposes a diagnosis of stage B cardiac failure, associated with greater risk of evolution to symptomatic ventricular dysfunction and death.