Identification of Early Heart Failure With Preserved Ejection Fraction After Preeclampsia by Exercise Stress Testing

What this Trial Is About

Cardiovascular disease (CVD) is the leading cause of death among women, but research has often focused on older women after cardiometabolic risks have accumulated. This study explores pregnancy as an early time of cardiovascular stress that may reveal a woman's risk for CVD, particularly looking at preeclampsia (PreE). Researchers aim to understand if PreE contributes directly to heart dysfunction later in life and to identify early signs of heart failure with preserved ejection fraction (HFpEF) linked to PreE. Participants include women diagnosed with PreE and a control group without PreE or pre-existing diabetes or chronic hypertension. The study involves recruiting women in their third trimester or upon admission to labor and delivery services. Researchers will collect data through surveys, blood pressure monitoring at home, blood tests, and specialized heart function tests including brachial artery reactivity testing and echocardiography at several time points: shortly after delivery, 12-16 weeks postpartum, and about one year postpartum. Exercise stress testing and leg lift maneuvers will assess heart function under stress. Participants will be monitored through blood pressure checks up to twice daily at home, with readings recorded electronically or manually. Heart imaging and exercise tests will measure heart function at rest and during stress. Blood and urine samples will be collected to study vascular and inflammatory markers related to PreE. The main outcome is to relate postpartum heart function changes to pregnancy-specific risk factors in women with and without PreE. Participants' health and safety will be closely followed throughout the study, which may last up to one year after delivery.

Exercise Testing After Preeclampsia