Cardiorespiratory fitness in women after severe pre-eclampsia

Figures & data

Figure 1. Flowchart of the study participants.

Table 1. Clinical characteristics of the study population.

	Previous preeclampsia n = 62	Controls n = 35	p value
Age, year	40 ± 4	39 ± 3	0.10
Age at index pregnancy, year	33 ± 4	32 ± 3	0.10
Time since delivery, years	7 ± 2	7 ± 1	0.25
Clinical registrations
Weight, kg	74 ± 11	64 ± 9	<0.01
BMI, kg/m^2	26.4 ± 3.7	22.5 ± 2.7	<0.01
Overweight, n (%)	23 (35)	5 (14)	0.02
Obesity, n (%)	10 (17)	0 (0)	0.01
SBP, mmHg	135 ± 18	114 ± 10	<0.01
DBP, mmHg	84 ± 12	68 ± 11	<0.01
HRrest,	82 ± 10	75 ± 8	0.02
[Hb], g × dL^−1	13.7 ± 2.0	14.4 ± 0.8	0.05
SpO2rest, %	98 ± 1	98 ± 2	0.13
Pulmonary function
FEV1, % of predicted	106 ± 11	110 ± 12	0.17
FEV1/FVC, %	81 ± 6	76 ± 19	0.22
DLCO, % of predicted	103 ± 13	104 ± 12	0.51
MMV, % of predicted	109 ± 19	113 ± 14	0.18
Cardiac function
LV EDV, ml	74 ± 7†	83 ± 11	<0.01
LV mass, gr	116 ± 21†	94 ± 25	<0.01
LV EF, %	53 ± 8†	61 ± 5	<0.01
CI, L/min/m^2	3.0 ± .4†	3.4 ± 0.6	0.02
LV GLS, %	−17.2 ± 2.4†	−21.3 ± 1.3	0.01
e` mean, cm/sek	11.0 ± 2.4†	15.3 ± 1.4	<0.01
E/e´	7.0 ± .5 †	5.2 ± 1.3	<0.01
Smokers
Never, n (%)	48 (80)	33 (94)	0.34
Former, n (%)	7 (12)	2 (6)	0.48
Current smoker, n (%)	5 (8)	0 (0)	0.08
Family history of CVD, n (%)	50 (83)	9 (26)	<0.01
Educational level
Primary school, n (%)	4 (7)	9 (26)	<0.01
Graduated high school, n (%)	15 (25)	4 (12)	0.11
Higher education, n (%)	41 (68)	31 (88)	0.03

Variables are presented as mean ± SD. Abbreviations; BMI, body mass index; CVD, cardiovascular disease; CI, cardiac index; DBP, diastolic blood pressure; DL_CO, diffusing capacity for carbon monoxide; EDV, end diastolic volume; FEV₁, forced expiratory volume in 1 sec; FVC, forced vital capacity; [Hb], hemoglobin concentration; LV, left ventricle; LV GLS, left ventricular global longitudinal strain; MVV, maximum voluntary ventilation. SBP, systolic blood pressure.

Table 2. Cardiopulmonary response during CPET.

	Previous preeclampsia n = 62	Controls n = 35	p value
Aerobic capacity
VO2peak, mL·min^−1	2277 ± 385	2518 ± 303	<0.01
VO2peak, mL·kg^−1·min^−1	31.4 ± 7.2	39.1 ± 5.4	<0.01
VO2peak, % predicted	91 ± 20	108 ± 15	<0.01
VO2 at VT, mL·min^−1	1788 ± 317	1998 ± 302	<0.03
VT in % of VO2peak	83 ± 22	80 ± 7	0.76
Cardiovascular response
SBPpeak, mmHg	196 ± 22	185 ± 13	0.05
DBPpeak, mmHg	88 ± 15	73 ± 11	0.01
HRpeak, beats·min^−1	177 ± 10	188 ± 10	0.03
Target HRpeak, % predicted	99 ± 15	104 ± 4	0.07
Oxygen pulsepeak, mL·HRpeak^−1	11.2 ± 2.3	13.7 ± 1.9	0.02
SVpeak, mL	54 ± 6	62 ± 7	0.01
COpeak, L·min^−1	9.6 ± 1,4	11.5 ± 1.2	<0.01
Pulmonary response
VEpeak, L·min^−1	85 ± 8	91 ± 12	0.09
Respiratory frequency, breath·min^−1	46 ± 9	42 ± 5	0.05
Breathing reserve, %	29.9 ± 7.3	31.7 ± 10.5	0.15
SpO2peak, %	92 ± 3	94 ± 3	0.16
Gas exchange variables
VE/VCO2 slope	27.6 ± 7.7	24.9 ± 3.3	0.08
VE/VCO2 ratio nadir	3.2 ± 4.5	26.1 ± 3.0	0.14
End-criteria variables for maximal effort
RER	1.23 ± .08	1.29 ± 0.07	0.25
Target HRpeak, % predicted	97 ± 5	104 ± 4	<0.01
RPE, BORG scalepeak 6–20	17.9 ± .7	17.8 ± 0.8	0.46
Blood lactate, mmol·L^−1	1.1 ± 2.5	11.5 ± 2.1	0.63
Recovery 2 min after exercise
SBP, mmHg	159 ± 21	130 ± 27	<0.01
DBP, mmHg	84 ± 11	66 ± 8	<0.01
HR, beats·min^−1	117 ± 16	105 ± 10	0.01
SpO2, %	97 ± 1	98 ± 1	0.13

Variables are presented as mean ± SD. Abbreviations: CO_peak, cardiac output at peak effort; CPET cardiopulmonary exercise test; DBP; diastolic blood pressure; HR_peak, peak heart rate; MVV, maximal voluntary ventilation, RER, respiratory exchange ratio; RPE, ratings of perceived exertion; SBP; systolic blood pressure; Sp, spectrophotometry; SV_peak, peak stroke volume; VE_peak, peak minute ventilation; VO2_peak, peak oxygen uptake; VT, ventilatory threshold.

Table 3. Physical activity in women at follow-up 7 years after severe preeclampsia.

	Previous preeclampsia n = 46	Controls n = 23	p value
Total registration time, days	6.24 ± 1.2	6.35 ± 0.9	0.457
Steps per day, n	6383 ± 1829	8825 ± 2452	<0.01
Counts per minute	306 ± 94	407 ± 104	<0.01
Total wear time, min	775 ± 91	812 ± 60	0.08
Sedentary time, min	72 ± 6	62 ± 7	<0.01
MVPA time, min	36 ± 14	58 ± 15	<0.01
Fulfilled WHOs recommendation, n (%)	25 (54%)	19 (83%)	0.02

Variables are presented as mean ± SD. Abbreviations: MVPA, moderate to vigorous physical activity; WHO, World Health Organization.

Table 4. Multiple regression analysis using VO_2peak as a dependent variable in women after severe preeclampsia.

VO2peak		Unstandardized Coefficients		Standardized Coefficients	95% Confidence Interval for Beta
		Beta	Std. Error	Beta	Lower Bound	Upper Bound	p value	$\mathrm{\Delta }$R^2
Model	PE group	−1201.03	1233.51		−2688.63	286.57		0.764
	CPM	2.84	0.96	0.32	0.27	4.77	0.004
	BMI	−63.21	24.30	0.29	−114.22	−12.21	0.001
	COpeak	−103.48	67.47	−0.31	−339.55	−67.42	0.013
	DBPrest	18.28	8.51	0.22	1.12	35.44	0.037

Note. Model = “Enter” method was applied in SPSS statistics; The Beta value represents the slope of the linear regression or the number of units the outcome variable (peak VO2) change with a 1-unit change in the predictor variable. Abbreviations: BMI, body mass index;CO_peak, cardiac output at peak exercise; CPM, counts per minute; DBP_rest; diastolic blood pressure at rest; $\mathrm{\Delta }$R², adjusted coefficient of determination.

Tranquilli AL, Brown MA, Zeeman GG, et al. The definition of severe and early-onset preeclampsia. statements from the International Society for the Study of Hypertension in Pregnancy (ISSHP). Pregnancy Hypertens. 2013;3(1):44–47. doi: 10.1016/j.preghy.2012.11.001

 PubMed Web of Science ®Google Scholar

Gestational hypertension and preeclampsia: ACOG practice bulletin, number 222. Obstet Gynecol. 2020;135(6):e237–e60. doi: 10.1097/AOG.0000000000003891

 PubMed Web of Science ®Google Scholar

Trost SG, McIver KL, Pate RR. Conducting accelerometer-based activity assessments in field-based research. Med Sci Sports Exercise. 2005;37(11 Suppl):S531–43. doi: 10.1249/01.mss.0000185657.86065.98

 PubMed Web of Science ®Google Scholar

Ersbøll AS, Bojer AS, Hauge MG, et al. Long-term cardiac function after peripartum cardiomyopathy and preeclampsia: A Danish nationwide, clinical follow-up study using maximal exercise testing and cardiac magnetic resonance imaging. J Am Heart Assoc. 2018;7(20):e008991. doi: 10.1161/JAHA.118.008991

 PubMed Web of Science ®Google Scholar

Data availability statement

No additional data is available.