Assessment of epicardial fat and carotid intima media thickness in gestational hypertension

• Published in: The journal of obstetrics and gynaecology research Vol. 44; no. 6; pp. 1072 - 1079
• Main Authors: Altin, Cihan, Yilmaz, Mustafa, Ozsoy, Hasmet M., Gezmis, Esin, Balci, Serdar, Tekindal, Mustafa A., Sade, Leyla E., Muderrisoglu, Haldun
• Format: Journal Article
• Language: English
• Published: Kyoto, Japan John Wiley & Sons Australia, Ltd 01-06-2018; Wiley Subscription Services, Inc
• Subjects: Arteriosclerosis; Atherosclerosis; cardiovascular disease; Cardiovascular diseases; Carotid artery; carotid intima media thickness; Diabetes mellitus; Echocardiography; epicardial fat thickness; Gestation; gestational hypertension; Hypertension; Pregnancy; Proteinuria; subclinical atherosclerosis; Ultrasound; Ventricle; gestational hypertension; cardiovascular disease; carotid intima media thickness; epicardial fat thickness; subclinical atherosclerosis
• ISSN: 1341-8076; 1447-0756
• DOI: 10.1111/jog.13631

Aim
Gestational hypertension (GHT) is a common disorder of pregnancy characterized by new onset hypertension without the presence of detectable proteinuria after 20 weeks of gestation. Epicardial fat thickness (EFT) and carotid intima media thickness (CIMT) are suggested as new predictors of subclinical atherosclerosis. Although the relationship between these parameters and essential hypertension has been demonstrated, this association in patients with GHT is still unknown. We aimed to investigate CIMT and EFT in patients with GHT.
Methods
A total of 90 patients (44 GHT and 46 controls) were enrolled. Patients with diabetes mellitus, chronic hypertension and cardiovascular disease (CVD) were excluded. In the third trimester, the mean CIMT at the far wall of both left and right common carotid arteries was measured on B‐mode duplex ultrasound. EFT was measured on the free wall of the right ventricle at the end systole in the parasternal long‐axis view by standard transthorasic 2D echocardiography.
Results
Unlike the mean CIMT (0.52 ± 0.13 mm vs 0.47 ± 0.11 mm; P = 0.078), the mean EFT was significantly higher in the GHT group compared to the controls (5.31 ± 1.68 mm vs 4.17 ± 1.16 mm; P = 0.002). In multivariate logistic regression analysis, among the most pertinent clinical variables, only EFT is an independent determinant of GHT (OR: 2.903; 95% confidence interval [CI]: 1.454–5.796; P = 0.003). In receiver operating characteristic (ROC) analysis, EFT >5.5 mm had 82.6% specificity and 52.3% sensitivity in predicting a diagnosis of GHT (ROC area under curve: 0.689, 95% CI: 0.577–0.802, P = 0.002).
Conclusion
Maternal EFT may be higher in pregnant women with GHT in comparison with those of controls.