This was the first study to use cardiac magnetic resonance (CMR) to determine myocardial structure in women with preeclampsia, and the first to demonstrate myocardial oedema as a component of increased left ventricular mass in these women.
Preeclampsia is a devastating high blood pressure problem of pregnancy, with childbirth the only cure. Professor Dennis’ team believed the key to understanding why preeclampsia occurs, and to finding better treatments, was to examine the heart using transthoracic echocardiography (TTE) and CMR, and aimed to improve understanding leading to better monitoring and the use of different medications to reduce complications in preeclampsia.
Professor Alicia Dennis at The Royal Women’s Hospital, Melbourne
Dr Sylvia Chen, Epworth Hospital, Melbourne
Dr Julian Castro, St Vincent’s Hospital, Melbourne
Dr Allan Wesley, The Prince Charles Hospital, Brisbane
The project was awarded $A66,591 through the ANZCA research grants program in 2017.
The specific aim was to define myocardial tissue characteristics using CMR and correlate with TTE in the antenatal period, determining whether observed changes return to non-pregnant reference values by six months post-birth.
This research work was the first-time in which analysis of the heart muscle was shown in patients with preeclampsia. It demonstrated that in a small cohort of patients the myocardial thickness observed on echocardiography was due to myocardial oedema, and not myocardial fibrosis, improving understanding of the pathophysiology of the condition, with implications for future treatments.
The study was an important one in a series of projects being led by Professor Dennis to understand the structure and function of the heart in people with preeclampsia, the underlying pathophysiology mechanism behind the condition, and potential solutions to the problem of high blood pressure in pregnant people. It contributed to Professor Dennis’ 2023 Fulbright Scholarship to undertake further work in this area at the Brigham and Women’s Hospital, and Harvard Medical School in Boston, USA, in 2023.
Chen SSM, Leeton L, Castro JM, Dennis AT. Myocardial tissue characterisation and detection of myocardial oedema by cardiovascular magnetic resonance in women with pre-eclampsia: a pilot study. International journal of obstetric anaesthesia. 2018 Nov; 36:56-65. https://doi.org/10.1016/j.ijoa.2018.07.004.
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