Echocardiographic assessment of maternal hemodynamics in preeclampsia at high altitude: a cross-sectional comparative study.

OBJECTIVE

To compare echocardiographic hemodynamic parameters between pregnant women with and without preeclampsia evaluated at high altitude.

STUDY

DESIGN

We conducted an observational cross-sectional study including pregnant women evaluated at a tertiary referral center located at 2640 m above sea level. Participants were classified according to the presence or absence of preeclampsia, diagnosed using International Society for the Study of Hypertension in Pregnancy criteria. All participants underwent standardized transthoracic echocardiography following international guidelines. Conditions known to significantly affect maternal hemodynamics were excluded.

RESULTS

A total of 105 pregnant women were included (35 with preeclampsia and 70 controls). Women with preeclampsia had higher cardiac output (median 5.18 L/min (IQR 3.90-6.04) vs. 4.52 L/min (IQR 3.67-5.15); p = 0.045) and higher left ventricular stroke volume (median 62.80 mL (IQR 53.04-71.41) vs. 55.65 mL (IQR 50.24-62.80); p = 0.019) compared with controls. Systemic vascular resistance was lower in the preeclampsia group, although the difference was not statistically significant (median 1243.36 dyn·s·cm-5 (IQR 1057.32-1594.65) vs. 1418.58 dyn·s·cm-5 (IQR 1234.44-1717.41); p = 0.06). Left ventricular systolic function and indexed chamber volumes were similar between groups.

CONCLUSIONS

Among pregnant women evaluated at high altitude, preeclampsia was associated with higher cardiac output and stroke volume, accompanied by mild alterations in diastolic filling, without significant differences in ventricular structure or systolic function. These findings underscore the heterogeneity of maternal hemodynamic presentation in preeclampsia and support further investigation of maternal cardiovascular adaptation in high-altitude settings.