Abstract：
OBJECTIVE: Hypertensive disorders of pregnancy (HDP) are among the leading causes of maternal morbidity and mortality. The primary objective of this study was to ascertain whether maternal cardiac remodeling is more prevalent in HDP than normotensive pregnancy and if significant change in aortic root size is involved. The secondary objective was to determine the types of cardiac remodeling often associated with HDP.
METHODS: A systematic search was conducted across four electronic databases, including Medline, PubMed, Cochrane and EMBASE. The reference lists of selected articles were also searched to ensure no relevant studies were missed. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed in this systematic review.
RESULTS: Out of 5,278 articles identified by the search terms, 9 were eligible for inclusion in the meta-analysis. The investigation unveiled a greater prevalence of maternal cardiac remodeling in HDP than normotensive pregnancies. The commonest type of maternal cardiac remodeling in both HDP and normotensive pregnancies was eccentric left ventricular hypertrophy, followed by concentric left ventricular remodeling which was more specific to HDP. Notably, left atrial diameter was significantly increased in HDP than normotensive pregnancies, suggesting higher prevalence of diastolic dysfunction. Additionally, the aortic root dimension was significantly increased in HDP than normotensive pregnancies.
CONCLUSIONS: This study underscores the importance of monitoring cardiac health in pregnancy, particularly in those with hypertensive disorders, in order to mitigate potential complications and improve maternal outcomes. Finally, the risk of aortic dissection that may occur as a long-term effect of aortic root enlargement in women with history of HDP ought to be investigated in future studies.
METHODS: A systematic search was conducted across four electronic databases, including Medline, PubMed, Cochrane and EMBASE. The reference lists of selected articles were also searched to ensure no relevant studies were missed. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed in this systematic review.
RESULTS: Out of 5,278 articles identified by the search terms, 9 were eligible for inclusion in the meta-analysis. The investigation unveiled a greater prevalence of maternal cardiac remodeling in HDP than normotensive pregnancies. The commonest type of maternal cardiac remodeling in both HDP and normotensive pregnancies was eccentric left ventricular hypertrophy, followed by concentric left ventricular remodeling which was more specific to HDP. Notably, left atrial diameter was significantly increased in HDP than normotensive pregnancies, suggesting higher prevalence of diastolic dysfunction. Additionally, the aortic root dimension was significantly increased in HDP than normotensive pregnancies.
CONCLUSIONS: This study underscores the importance of monitoring cardiac health in pregnancy, particularly in those with hypertensive disorders, in order to mitigate potential complications and improve maternal outcomes. Finally, the risk of aortic dissection that may occur as a long-term effect of aortic root enlargement in women with history of HDP ought to be investigated in future studies.
摘要：
目的：妊娠期高血压疾病（HDP）是孕产妇发病和死亡的主要原因。这项研究的主要目的是确定在HDP中母体心脏重塑是否比正常血压妊娠更普遍，以及是否涉及主动脉根大小的显着变化。次要目标是确定通常与HDP相关的心脏重塑类型。
方法：在四个电子数据库中进行了系统搜索，包括Medline,PubMed,Cochrane和EMBASE.还搜索了选定文章的参考列表，以确保没有遗漏相关研究。本系统评价遵循系统评价和荟萃分析（PRISMA）指南的首选报告项目。
结果：在由搜索词确定的5,278篇文章中，9人符合纳入荟萃分析的条件。调查揭示了HDP中母体心脏重塑的患病率高于正常血压妊娠。HDP和正常血压妊娠中最常见的母体心脏重塑类型是偏心左心室肥大，其次是同心左心室重构，对HDP更具特异性。值得注意的是,与正常血压妊娠相比，HDP患者的左心房直径明显增加，提示舒张功能障碍的患病率较高。此外,与血压正常的妊娠相比,HDP的主动脉根部尺寸显著增加.
结论：本研究强调了孕期监测心脏健康的重要性，特别是那些患有高血压疾病的人，为了减轻潜在的并发症和改善产妇结局。最后,在有HDP病史的女性患者中,主动脉夹层的风险可能是主动脉根部扩大的长期效应,应该在未来的研究中进行调查.
方法：在四个电子数据库中进行了系统搜索，包括Medline,PubMed,Cochrane和EMBASE.还搜索了选定文章的参考列表，以确保没有遗漏相关研究。本系统评价遵循系统评价和荟萃分析（PRISMA）指南的首选报告项目。
结果：在由搜索词确定的5,278篇文章中，9人符合纳入荟萃分析的条件。调查揭示了HDP中母体心脏重塑的患病率高于正常血压妊娠。HDP和正常血压妊娠中最常见的母体心脏重塑类型是偏心左心室肥大，其次是同心左心室重构，对HDP更具特异性。值得注意的是,与正常血压妊娠相比，HDP患者的左心房直径明显增加，提示舒张功能障碍的患病率较高。此外,与血压正常的妊娠相比,HDP的主动脉根部尺寸显著增加.
结论：本研究强调了孕期监测心脏健康的重要性，特别是那些患有高血压疾病的人，为了减轻潜在的并发症和改善产妇结局。最后,在有HDP病史的女性患者中,主动脉夹层的风险可能是主动脉根部扩大的长期效应,应该在未来的研究中进行调查.
