Echocardiography and Biomarker-based Regression Models for the Detection of Gestational Hypertension in Pregnant Women

Authors

  • Dolina Gencheva Medical University of Plovdiv, First Department of Internal Diseases, Section of Cardiology and University Multi-profile Hospital for Active Treatment “Sveti Georgi”, Clinic of Cardiology, Bulgaria
  • Fedya Nikolov Medical University of Plovdiv, First Department of Internal Diseases, Section of Cardiology and University Multi-profile Hospital for Active Treatment “Sveti Georgi”, Clinic of Cardiology, Bulgaria
  • Ekaterina Uchikova Medical University of Plovdiv, Department of Obstetrics and Gynaecology and University Multi-profile Hospital for Active Treatment “Sveti Georgi”, Clinic of Obstetrics and Gynaecology, Bulgaria
  • Rosen Mihaylov ndependent Medical Diagnostic Laboratory “RAMUS” and Medical College “Jordanka Filaretova”, Bulgaria
  • Blagovesta Pencheva Independent Medical Diagnostic Laboratory “RAMUS”, Bulgaria

DOI:

https://doi.org/10.7546/CRABS.2024.01.16

Keywords:

gestational hypertension, regression models, placental growth factor, echocardiography, pregnancy, global longitudinal strain

Abstract

Hypertensive disorders of pregnancy are characterized by both higher cardiovascular risk for women and more pronounced structural and functional changes of the heart. Certain biomarkers and echocardiographic parameters could be utilized in regression models for more accurate detection of the presence of those hypertensive disorders.

The aim of the study was to compare the differentiating abilities of several regression models for statistical certainty in establishing the diagnosis of gestational hypertension in pregnant women using echocardiographic parameters and biomarkers.

A prospective, single-centre, clinical-epidemiological study was conducted with the participation of 36 women with gestational hypertension and 50 maternal and gestational age-matched healthy pregnant controls. Certain echocardiographic parameters and serum biomarkers – placental growth factor (PlGF), galectin-3, high-sensitivity C-reactive protein and Interleukin-6, were analyzed for the women using ROC curve analysis and binary logistic regression.

We constructed three regression models, allowing very good differentiation between women with gestational hypertension and those with normotensive pregnancy. The model that included PlGF, left ventricular and right ventricular global longitudinal strain (LV GLS, RV GLS) had AUC 0.81, sensitivity and specificity of 86% and accuracy of 86%. The LV GLS and PlGF model had AUC of 0.90 with sensitivity 83%, specificity 88%, and accuracy 86%; and the LV GLS and RV GLS had AUC of 0.83, sensitivity 67%, specificity 92%, and accuracy 81%.

All three combined models showed better accuracy compared to PlGF, LV GLS, RV GLS or any other echocardiographic parameter or biomarker alone, which could be promising for their implementation in clinical practice.

Author Biographies

Dolina Gencheva, Medical University of Plovdiv, First Department of Internal Diseases, Section of Cardiology and University Multi-profile Hospital for Active Treatment “Sveti Georgi”, Clinic of Cardiology, Bulgaria

Mailing Addresses:
Medical University of Plovdiv,
First Department of Internal Diseases, Section of Cardiology
66 Peshtersko Shosse Blvd,
4001 Plovdiv, Bulgaria

and

University Multi-profile Hospital for Active Treatment “Sveti Georgi”,
Clinic of Cardiology
66 Peshtersko Shosse Blvd,
4001 Plovdiv, Bulgaria

E-mail: sylvanas@mail.bg

Fedya Nikolov, Medical University of Plovdiv, First Department of Internal Diseases, Section of Cardiology and University Multi-profile Hospital for Active Treatment “Sveti Georgi”, Clinic of Cardiology, Bulgaria

Mailing Addresses:
Medical University of Plovdiv,
First Department of Internal Diseases, Section of Cardiology
66 Peshtersko Shosse Blvd,
4001 Plovdiv, Bulgaria

and

University Multi-profile Hospital for Active Treatment “Sveti Georgi”,
Clinic of Cardiology
66 Peshtersko Shosse Blvd,
4001 Plovdiv, Bulgaria

E-mail: fedyany@yahoo.com

Ekaterina Uchikova, Medical University of Plovdiv, Department of Obstetrics and Gynaecology and University Multi-profile Hospital for Active Treatment “Sveti Georgi”, Clinic of Obstetrics and Gynaecology, Bulgaria

Mailing Addresses:
Medical University of Plovdiv,
Department of Obstetrics and Gynaecology
66 Peshtersko Shosse Blvd,
4001 Plovdiv, Bulgaria

and

University Multi-profile Hospital for Active Treatment “Sveti Georgi”,
Clinic of Obstetrics and Gynaecology
66 Peshtersko Shosse Blvd,
4001 Plovdiv, Bulgaria

E-mail: euchikova@yahoo.com

Rosen Mihaylov, ndependent Medical Diagnostic Laboratory “RAMUS” and Medical College “Jordanka Filaretova”, Bulgaria

Mailing Addresses:
Independent Medical Diagnostic Laboratory “RAMUS”
2--4 Angista St,
1527 Sofia, Bulgaria

and

Medical College “Jordanka Filaretova”
3 Jordanka Filaretova St,
1606 Sofia, Bulgaria

E-mail: rossenmih@abv.bg

Blagovesta Pencheva, Independent Medical Diagnostic Laboratory “RAMUS”, Bulgaria

Mailing Address:
Independent Medical Diagnostic Laboratory “RAMUS”
2--4 Angista St,
1527 Sofia, Bulgaria

E-mail: blagovesta.pencheva@ramuslab.com

Downloads

Published

29-01-2024

How to Cite

[1]
D. Gencheva, F. Nikolov, E. Uchikova, R. Mihaylov, and B. Pencheva, “Echocardiography and Biomarker-based Regression Models for the Detection of Gestational Hypertension in Pregnant Women”, C. R. Acad. Bulg. Sci. , vol. 77, no. 1, pp. 137–147, Jan. 2024.

Issue

Section

Medicine