Myocardial mechanics in hypertensive disorders of pregnancy: a systematic review and meta-analysis

Journal article

O'Driscoll, J., Giorgione, V, Edwards, J., Wiles, J., Sharma, R and Thilaganathan Myocardial mechanics in hypertensive disorders of pregnancy: a systematic review and meta-analysis. Hypertension.
AuthorsO'Driscoll, J., Giorgione, V, Edwards, J., Wiles, J., Sharma, R and Thilaganathan
Abstract

Global longitudinal strain (GLS) is becoming routinely used to direct the medical management of various cardiac diseases, but its application in pregnancy is unclear. Our objective was to perform a meta-analysis and pool multiple study data to consolidate the evidence base for the role of GLS in the assessment of women with hypertensive disorders of pregnancy (HDP). Electronic database searches were performed in PubMed/Medline and EMBASE for research articles reporting GLS in pregnancies complicated by HDP and normotensive pregnancies that have been published up to September 2021. The meta-analysis included 17 studies with a pooled sample size of 1723 participants, which included 951 women with HDP, of which 680 were pre-eclamptic (PE), and 772 controls. The primary random-effects pooled analysis demonstrated a statistically significant weighted mean difference (MD) in GLS between the HDP and control group (MD: 3.08%, CI=2.33-3.82, p<0.001). When analysed including only PE studies, there was also a statistically significant mean difference (MD: 2.98%, 95% CI=1.97-3.99, p<0.001). This meta-analysis demonstrates that HDP is associated with greater cardiac maladaptation, evidenced by a significantly reduced GLS compared to normal pregnancy. Echocardiography should be considered as a screening tool in women with HDP to enable early cardiovascular risk prevention through national initiatives.

KeywordsCardiac mechanics ; Hypertension; Pregnancy; Preeclampsia; Hypertensive disorders of pregnancy; Echocardiography; Meta-analysis
JournalHypertension
PublisherAmerican Heart Association
Lippincott, Williams and Wilkins
ISSN0194-911X
1524-4563
Publication process dates
Accepted27 Oct 2021
Deposited11 Nov 2021
Accepted author manuscript
File Access Level
Restricted
Output statusIn press
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Devereux, G., Wiles, J. and Swaine, I. 2011. Markers of isometric training intensity and their relationship with training-induced reductions in resting blood pressure. Journal of Sports Sciences. 29 (7), pp. 715-724. https://doi.org/10.1080/02640414.2011.552113
The relationship between indices of fatigue and femoral artery post exercise hyperaemia after double-leg isometric exercise at increasing intensities
Smith, J., Wiles, J., Swaine, I. and Coleman, D. 2012. The relationship between indices of fatigue and femoral artery post exercise hyperaemia after double-leg isometric exercise at increasing intensities.
The effects of four weeks home-based isometric exercise training on resting blood pressure
Goldring, N., Wiles, J. and Coleman, D. 2012. The effects of four weeks home-based isometric exercise training on resting blood pressure.
The effects of isometric wall squat exercise on heart rate and blood pressure in a normotensive population
Goldring, N., Wiles, J. and Coleman, D. 2010. The effects of isometric wall squat exercise on heart rate and blood pressure in a normotensive population.
The influence of nutritional interventions on the measurement of gross efficiency during cycling
Cole, M., Coleman, D. and Wiles, J. 2012. The influence of nutritional interventions on the measurement of gross efficiency during cycling.
The effect of short-term dietary manipulation on gross efficiency during cycling
Cole, M., Coleman, D. and Wiles, J. 2011. The effect of short-term dietary manipulation on gross efficiency during cycling.
The relationship between EMG and either heart rate or blood pressure during a single-leg incremental isometric exercise test
Swaine, I., Baross, T., Kay, T. and Wiles, J. 2009. The relationship between EMG and either heart rate or blood pressure during a single-leg incremental isometric exercise test.
Can 4 weeks of isometric exercise lower resting blood pressure in young, healthy, active men?
Swaine, I., Devereux, G. and Wiles, J. 2009. Can 4 weeks of isometric exercise lower resting blood pressure in young, healthy, active men?
Effect of isometric exercise training on resting blood pressure: A meta-analysis of controlled trials
Swaine, I., Owen, A. and Wiles, J. 2009. Effect of isometric exercise training on resting blood pressure: A meta-analysis of controlled trials.
Effects of physical activity, performed in accordance with the current recommendations, on CVD risk factors in 40-65 year old men
Perkins, G., Owen, A., Kearney, E., Wiles, J. and Swaine, I. 2007. Effects of physical activity, performed in accordance with the current recommendations, on CVD risk factors in 40-65 year old men.
Differing autonomic responses to dobutamine stress in the presence and absence of myocardial ischaemia
Sharma, R., O'Driscoll, J., Bromley, P., Sritharan, M. and Rosen, S. 2008. Differing autonomic responses to dobutamine stress in the presence and absence of myocardial ischaemia.
Dobutamine stress echocardiography accurately detects significant coronary artery disease in Indian Asians living in the United Kingdom
Itam, S., O'Driscoll, J., Milad, E. and Sharma, R. 2008. Dobutamine stress echocardiography accurately detects significant coronary artery disease in Indian Asians living in the United Kingdom.
The effects of a high-protein, paleolithic-type diet on body composition and exercise performance in amateur mixed martial artists
Slee, A., O'Driscoll, J., Burnet, S., Hughes, G. and Chen, M. 2009. The effects of a high-protein, paleolithic-type diet on body composition and exercise performance in amateur mixed martial artists.
Subjective global assessment is an independent predictor of cardiac ischaemia in patients with mild chronic kidney disease
Aldous, G., Sharma, R., O'Driscoll, J., Ashby, D., Tarn, F. and Choi, P. 2010. Subjective global assessment is an independent predictor of cardiac ischaemia in patients with mild chronic kidney disease.
A National Health Service hospital's cardiac rehabilitation programme: a qualitative analysis of provision
O'Driscoll, J., Shave, R. and Cushion, C. 2007. A National Health Service hospital's cardiac rehabilitation programme: a qualitative analysis of provision. Journal of Clinical Nursing. 16 (10), pp. 1908-1918. https://doi.org/10.1111/j.1365-2702.2007.01815.x
Inequalities in the training and implementation of cardiac rehabilitation in the United Kingdom
O'Driscoll, J. and Sharma, R. 2009. Inequalities in the training and implementation of cardiac rehabilitation in the United Kingdom. in: Bennington, E. (ed.) Horizons in World Cardiovascular Research Hauppauge, New York Nova Science Publishers.
Effect of caffeinated coffee on running speed, respiratory factors, blood lactate and perceived exertion during 1500-m treadmill running
Wiles, J., Bird, S., Hopkins, J. and Riley, M. 1992. Effect of caffeinated coffee on running speed, respiratory factors, blood lactate and perceived exertion during 1500-m treadmill running. British Journal of Sports Medicine. 26 (2), pp. 116-120. https://doi.org/10.1136/bjsm.26.2.116
Effect of pre-exercise protein ingestion upon VO2, R and perceived exertion during treadmill running
Wiles, J., Woodward, R. and Bird, S. 1991. Effect of pre-exercise protein ingestion upon VO2, R and perceived exertion during treadmill running. British Journal of Sports Medicine. 25 (1), pp. 26-30. https://doi.org/10.1136/bjsm.25.1.26
Effectiveness of two glycerol ingestion strategies on 40-km cycling time trial performance
Brickell, L., Balmer, J., Theakston, S., Wiles, J. and Bird, S. 2001. Effectiveness of two glycerol ingestion strategies on 40-km cycling time trial performance. Journal of Sports Sciences. 20 (1), pp. 46-47. https://doi.org/10.1080/026404102317126164
We can work it out
Morrissey, M. and Wiles, J. 2001. We can work it out. Nursing Times. 97 (47), pp. 34-36.
Effects of isometric exercise training intensity upon reductions in resting systolic blood pressure
Wiles, J., Coleman, D. and Swaine, I. 2008. Effects of isometric exercise training intensity upon reductions in resting systolic blood pressure.
A novel method for the performance of isometric exercise in the home
Wiles, J., Coleman, D., Dunford, M. and Swaine, I. 2004. A novel method for the performance of isometric exercise in the home.
The precision with which isometric exercise training can be performed according to a given heart rate
Swaine, I., Wiles, J. and Coleman, D. 2008. The precision with which isometric exercise training can be performed according to a given heart rate.
Effects of three types of isometric leg exercise at the same relative exercise intensities on blood pressure
Swaine, I., Wiles, J., Dunford, M. and Coleman, D. 2004. Effects of three types of isometric leg exercise at the same relative exercise intensities on blood pressure.
The freely chosen contribution of the leg kick to the total power during simulated front crawl swimming on a onland ergometer
Swaine, I., Dunford, M., Wiles, J., Coleman, D., Hunter, A. and Carlton, K. 2006. The freely chosen contribution of the leg kick to the total power during simulated front crawl swimming on a onland ergometer.
The relationship between selected cardiovascular variables and exercise intensity during continuous and discontinuous incremental exercise tests
Allum, S., Wiles, J., Coleman, D. and Swaine, I. 2006. The relationship between selected cardiovascular variables and exercise intensity during continuous and discontinuous incremental exercise tests.
Familiarisation and reliability of sprint test indices during laboratory and field assessment
Hopker, J., Coleman, D., Wiles, J. and Galbraith, A. 2009. Familiarisation and reliability of sprint test indices during laboratory and field assessment. Journal of Sports Science and Medicine. 8 (4), pp. 528-532.
Occurrence of injury during officer safety training at Kent Police
Andrew, J., Henry, T., Coleman, D. and Wiles, J. 2009. Occurrence of injury during officer safety training at Kent Police. The Police Journal. 82 (3), pp. 265-274. https://doi.org/10.1350/pojo.2009.82.3.455
The effects of performing isometric training at two exercise intensities in healthy young males
Wiles, J., Coleman, D. and Swaine, I. 2010. The effects of performing isometric training at two exercise intensities in healthy young males. European Journal of Applied Physiology. 108 (3), pp. 419-428. https://doi.org/10.1007/s00421-009-1025-6
The effect of training volume and intensity on competitive cyclists’ efficiency
Hopker, J., Coleman, D., Passfield, L. and Wiles, J. 2010. The effect of training volume and intensity on competitive cyclists’ efficiency. Applied Physiology, Nutrition and Metabolism. 35 (1), pp. 17-22. https://doi.org/10.1139/H09-124
Reductions in resting blood pressure after 4 weeks of isometric exercise training
Devereux, G., Wiles, J. and Swaine, I. 2010. Reductions in resting blood pressure after 4 weeks of isometric exercise training. European Journal of Applied Physiology. 109 (4), pp. 601-606. https://doi.org/10.1007/s00421-010-1394-x
Effect of isometric exercise on resting blood pressure: a meta analysis
Owen, A., Wiles, J. and Swaine, I. 2010. Effect of isometric exercise on resting blood pressure: a meta analysis. Journal of Human Hypertension. 24 (12), pp. 796-800. https://doi.org/10.1038/jhh.2010.13
Reproducibility of limb power outputs and cardiopulmonary responses to exercise using a novel swimming training machine
Swaine, I., Hunter, A., Carlton, K., Wiles, J. and Coleman, D. 2010. Reproducibility of limb power outputs and cardiopulmonary responses to exercise using a novel swimming training machine. International Journal of Sports Medicine. 31 (12), pp. 854-859. https://doi.org/10.1055/s-0030-1265175
The effect of sodium bicarbonate ingestion on 1500-m racing time
Bird, S., Wiles, J. and Robbins, J. 1995. The effect of sodium bicarbonate ingestion on 1500-m racing time. Journal of Sports Sciences. 13 (5), pp. 399-403. https://doi.org/10.1080/02640419508732255
Validity and reliability of the Ergomopro Powermeter
Kirkland, A., Coleman, D., Wiles, J. and Hopker, J. 2008. Validity and reliability of the Ergomopro Powermeter. International Journal of Sports Medicine. 29 (11), pp. 913-916. https://doi.org/10.1055/s-2008-1038621
The relationships between exercise intensity, heart rate, and blood pressure during an incremental isometric exercise test
Wiles, J., Allum, S., Coleman, D. and Swaine, I. 2007. The relationships between exercise intensity, heart rate, and blood pressure during an incremental isometric exercise test. Journal of Sports Sciences. 26 (2), pp. 155-162. https://doi.org/10.1080/02640410701370655
A novel method for the performance of isometric exercise in the home
Wiles, J., Coleman, D., Dunford, M. and Swaine, I. 2005. A novel method for the performance of isometric exercise in the home. Journal of Sports Sciences. 23 (8), pp. 795-803. https://doi.org/10.1080/02640410400021658
The effects of caffeine ingestion on performance time, speed and power during a laboratory-based 1 km cycling time-trial
Wiles, J., Coleman, D., Tegerdine, M. and Swaine, I. 2006. The effects of caffeine ingestion on performance time, speed and power during a laboratory-based 1 km cycling time-trial. Journal of Sports Sciences. 24 (11), pp. 1165-1171. https://doi.org/10.1080/02640410500457687
Validity and reliability of a new isometric hand dynamometer
Wiles, J., Boyson, H., Balmer, J. and Bird, S. 2001. Validity and reliability of a new isometric hand dynamometer. Sports Engineering. 4 (3), pp. 147-152. https://doi.org/10.1046/j.1460-2687.2001.00080.x
Relationships between pulse wave velocity and heart rate variability in healthy men with a range of moderate-to-vigorous physical activity levels
Perkins, G., Owen, A., Swaine, I. and Wiles, J. 2006. Relationships between pulse wave velocity and heart rate variability in healthy men with a range of moderate-to-vigorous physical activity levels. European Journal of Applied Physiology. 98 (5), pp. 516-523. https://doi.org/10.1007/s00421-006-0303-9
Differences in efficiency between trained and recreational cyclists
Hopker, J., Coleman, D. and Wiles, J. 2007. Differences in efficiency between trained and recreational cyclists. Applied Physiology, Nutrition and Metabolism. 32 (6), pp. 1036-1042. https://doi.org/10.1139/H07-070
Reliability of sprint test indices in well-trained cyclists
Coleman, D., Wiles, J., Nunn, M. and Smith, M. 2005. Reliability of sprint test indices in well-trained cyclists. International Journal of Sports Medicine. 26 (5), pp. 383-387. https://doi.org/10.1055/s-2004-821226
Power output measurement during treadmill cycling
Coleman, D., Wiles, J., Davison, R., Smith, M. and Swaine, I. 2007. Power output measurement during treadmill cycling. International Journal of Sports Medicine. 28 (6), pp. 525-530. https://doi.org/10.1055/s-2006-955888