Left ventricular mass and myocardial scarring in women with hypertensive disorders of pregnancy.

Hypertensive disorders of pregnancy (HDP) predict future cardiovascular events. We aim to investigate relations between HDP history and subsequent hypertension (HTN), myocardial structure and function, and late gadolinium enhancement (LGE) scar. We evaluated a prospective cohort of women with suspected ischaemia with no obstructive coronary artery disease (INOCA) who underwent stress/rest cardiac magnetic resonance imaging (cMRI) with LGE in the Women's Ischemia Syndrome Evaluation-Coronary Vascular Dysfunction study. Self-reported history of pregnancy and HDP (gestational HTN, pre-eclampsia, toxaemia and eclampsia) were collected at enrollment. In our cohort of 346, 20% of women report a history of HDP. HDP history was associated with 3.2-fold increased odds of HTN. Women with a history of In a high-risk cohort of women with suspected INOCA, 20% had a history of HDP. Women with HDP history were more likely to develop HTN. Our study demonstrates higher LV mass in women with HDP and concomitant HTN. Although the presence of LGE scar was not different in women with and without HDP history, we observed a trend towards larger scar size in women with HDP. Future studies are needed to better assess the relationship of HDP and cardiac morphology and LGE scarring in a larger cohort of women.

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Competing interests: Dr Bairey Merz reports personal fees from iRhythm, other from Sanofi, other from Abbott Diagnostics, during the conduct of the study. Dr Handberg reports grants from NIH/NHLBI, during the conduct of the study; grants from Aastom Biosciences, Amgen, Amorcyte, AstraZeneca, Biocardia, Boehringer Ingelheim, Brigham and Women’s Hospital, Capricor, Cytori Therapeutics, Department of Defense, Direct Flow Medical, Duke Clinical Research Institute, East Carolina University, Everyfit Inc, Gilead, Ionis, Medtronic, Merck grants from NIH/NCATS, grants from BioCardia BC-14-001-02; Mesoblast, Inc MSB-MPC-CHF001; Ventrix, Inc; Athersys Inc. AMI MultiStem; Verily Life Sciences LLC-Project Baseline OSMB; Ironwood MSB-MPC-CHF00-DMC, Imbria Pharmaceuticals Inc; Milestone Pharmaceuticals Inc; Caladrius Biosciences, Inc; Gatorade Trust; and McJunkin Family Foundation, outside the submitted work. Dr Minissian reports consulting with Amgen, Medical Advisory Board; honorarium NACCME, LLC Co-Chair for CME; Vox Media; Medtelligence; Minneapolis Heart Institute; Primed; Good Samaritan Hospital, Los Angeles, California; Cardiometabolic Health Congress; American Heart Association; National Lipid Association; Preventive Cardiovascular Nurses Association; American College of Cardiology. All other authors have no disclosures to report.