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Cardiovascular Complication in Preeclampsia: Can it be Predicted Electrocardiographically?

Author : R.A. Raharjo, D. E. Wismiyarso, A. P. Mangkoesoebroto, A. Perdana, U. Bahrudin, A.Y.A.B. Mochtar, Y
Upload Date : 19-04-2018

Background: Preeclampsia is common and causing significant morbidity and mortality, both to the mother and the baby(ies). The occurrence of cardiovascular complication aggravates this already severe disease. Efforts have been done to predict the complications of preeclampsia, but some modalities like echocardiography and biomarkers are neither available nor feasible in developing countries. On the other hand, electrocardiography (ECG) is cheap, non-invasive, widely available, and routinely performed in preeclampsia, yet its role in predicting cardiovascular complication in preeclampsia is not known.

Objective: This study aimed to investigate the association between ECG and clinical parameters with the occurrence of cardiovascular complication in preeclampsia patients.

Methods: This cross-sectional analytic study used retrospective data from medical records of patients with preeclampsia in Dr. Kariadi General Hospital from January 2016 to July 2017. Characteristic data and ECG parameters rate, axis, PR interval, QRS complex duration, Sokolow-Lyon voltage, corrected QT interval, left atrial abnormality, and myocardial ischemia were collected. Bivariate analysis was performed between ECG and clinical parameters with the occurrence of cardiovascular complication. Linear regression analysis was performed if there were more than one variable had association with p<0.25.

Results: Sixty-eight patients with preeclampsia were included, with a mean age of 30.2 years. Cardiovascular complications occurred in 16 (23.5%) patients, with 14 of them having pulmonary edema. Univariate analysis showed that heart rate and hemoglobin level had a significant association with the occurrence of cardiovascular complication (p=0.035 and p=0.033, respectively); while other ECG parameters didn’t show significant association. The linear regression analysis showed that no significant independent predictor was found.

Conclusion: Data of this study showed that ECG parameters aren’t able to predict cardiovascular complication in patients with preeclampsia, but heart rate and hemoglobin level have significant association with cardiovascular complication in those patients.

KEYWORDS : Preeclampsia, cardiovascular complication, electrocardiography

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