Speckle tracking echocardiography for cardiac assessment in pregnant women with preeclampsia: a scoping review

Salimena, Elisabeth Dias Winter; Salimena, Anabelle Dias Winter; Carvalho, Augusto Monteiro de Castro Xavier de; Gheller, Theresa Laurenti; Laufer, Erik de Abreu; Sá, Renato Augusto Moreira de

doi:10.1590/1806-9304202520240267-en

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REVIEW • Rev. Bras. Saude Mater. Infant. 25 • 2025 • https://doi.org/10.1590/1806-9304202520240267-en linkcopy

Speckle tracking echocardiography for cardiac assessment in pregnant women with preeclampsia: a scoping review

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objectives: to map existing scientific evidence on the use of echocardiography with the Speckle Tracking (STE) technique in pregnant women with preeclampsia (PE), compared to normotensive pregnant women.

Methods: this scoping review was conducted following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines and the Joanna Briggs Institute methodology. The research protocol was registered in the Open Science Framework. Searches were performed in PubMed, Embase, Web of Science, BVS, and the Cochrane Database of Systematic Reviews, as well as in the gray literature via Google Scholar. Two independent reviewers selected the articles based on inclusion criteria, resulting in 12 studies.

Results: in total, the studies analyzed included 951 pregnant women (473 with PE and 478 controls). Most studies reported less negative Global Longitudinal Strain (GLS) values in women with PE (mean of -17%) compared to normotensive controls (mean of -20%), suggesting subclinical cardiac dysfunction in the PE group.

Conclusion: these findings highlight the potential of STE to detect early myocardial changes in preeclampsia, even before a reduction in the left ventricular ejection fraction. Further research is needed to explore the systematic use of STE in high-risk prenatal care to promote maternal cardiovascular health.

Key words
Preeclampsia; Global longitudinal strain; Echocardiography

Study	Location/Year	Type of study	Population		Gestational age (weeks)	GLS+DP. %	Exclusion criteria	Software
Study	Location/Year	Type of study	Population		$\bar{x}$ ± DP	GLS+DP. %	Exclusion criteria	Software
Buddeberg et al.,²³	United Kingdom, 2018	Case-control	PE	30	38.26 ± 1.54	-13.32 ± 2.37	Any cardiovascular comorbidity, multiple pregnancies	GE EchoPac
Buddeberg et al.,²³	United Kingdom, 2018	Case-control	Control	40	39.31 ± 1.02	-17.61 ± 1.89	Any cardiovascular comorbidity, multiple pregnancies	GE EchoPac
Levine et al.,²⁴	United States, 2019	Case-control	PE	29	31.3 ± 3.9	-12.94 ± 3.4	Pre-existing CVD, chronic SAH, or multiple pregnancies	TomTec
Levine et al.,²⁴	United States, 2019	Case-control	Control	29	31.7 ± 3.61	-15.06 ± 3.1	Pre-existing CVD, chronic SAH, or multiple pregnancies	TomTec
Mostafavi et al.,¹¹	Iran, 2019	Case-control	PE	60	33.4 ± 3.54	-18.69 ± 2.28	Poor image quality, SAH, preexisting diabetes, abnormal dilation in at least one of the four cardiac chambers, EF <55%, RV dilation or hypokinesia, valvular disorders, pericardial disease, uncorrected cognition, congenital heart disease, and diastolic disorders	Philips Epic 7
Mostafavi et al.,¹¹	Iran, 2019	Case-control	Control	40	32.25 ± 4.65	-19.39 ± 3.49		Philips Epic 7
Pan et al.,²⁶	China, 2019	Case-control	PE	33	34.7 ± 5.0	-15.8 ± 3.2	Pre-existing comorbidities, smoking, multiple pregnancies	GE EchoPac
Pan et al.,²⁶	China, 2019	Case-control	Control	20	34.7 ± 3.4	-16.8 ± 3.0	Pre-existing comorbidities, smoking, multiple pregnancies	GE EchoPac
Paudel et al.,²⁷	Turkey, 2020	Case-control	PE	55	33 ± 4.0	-18 ± 2.6	SAH or preexisting heart disease, DM, kidney or liver disease, multiple pregnancies, alcoholism or smoking	QLAB Philips
Paudel et al.,²⁷	Turkey, 2020	Case-control	Control	35	34 ± 3.0	-19.8 ± 2.1		QLAB Philips
Paulino RFB et al.,²⁸	Brazil, 2023	Case-control	PE	26	33.0 ± 2.8	-19.0 ± 2.3	Limited acoustic window, previous heart disease, chronic kidney disease, stroke, DM, cardiotoxic medications, and psychiatric disorders	GE EchoPac
Paulino RFB et al.,²⁸	Brazil, 2023	Case-control	Control	26	31.5 ± 3.6	-21.4 ± 1.7		GE EchoPac
Shahul et al.,²¹	United States, 2016	Case-control	PE	62	32.8 ± 3.7	-18.9 ± 3.3	Pre-existing ischemic or valvular heart disease, lung disease, diabetes, or labor	Tomtec
Shahul et al.,²¹	United States, 2016	Case-control	Control	105	30.7 ± 4.3	-23.9 ± 2.7		Tomtec
Shahul et al.,²²	United States, 2012	Case-control	PE	11	36.6 ± 3.34	-13.7 ± 4.6	Pre-existing cardiovascular disease, lung disease, and diabetes	TomTec
Shahul et al.,²²	United States, 2012	Case-control	Control	17	38 ± 2.97	-20.1 ± 3.48		TomTec
Vaught et al.,²⁹	United States, 2018	Case-control	PE	63	33.1 ± 3.6	-19.1 ± 1.5	Pre-existing valvular or congenital heart disease, cardiomyopathy, pulmonary hypertension, previous cardiac surgery, pulmonary embolism, systemic lupus, any connective tissue disease, antiphospholipid syndrome, or interstitial lung disease, multiple pregnancies	Epsilon
Vaught et al.,²⁹	United States, 2018	Case-control	Control	36	31.8 ± 4.9	-20.1 ± 1.5		Epsilon
Yu et al.,³⁰	China, 2018	Case-control	PE	25	32.0 ± 6.0	-13.7 ± 3.1	Gestational diabetes, or preexisting hypertension or cardiovascular disease, multiple pregnancies	VVI
Yu et al.,³⁰	China, 2018	Case-control	Control	30	33.0 ± 4.0	-21.9 ± 3.88		VVI
Zaman et al.,⁹	India, 2018	Case-control	PE	30	35.0 ± 2.8	-15.63 ± 1.69	IG <34 weeks, heart disease, coronary heart disease, cardiomyopathies, etc.), chronic or gestational hypertension, renal impairment, multiple pregnancies, diabetes, obesity, moderate to severe anemia	QLAB Philips
Zaman et al.,⁹	India, 2018	Case-control	Control	30	35.0 ± 1.1	-20.86 ± 1.52		QLAB Philips
Bogdan et al.,³¹	Romania, 2024	Case-control	PE	49	27.3 ± 3.7	-20.7 ± 1.55	Chronic hypertension, heart disease, diabetes, cerebrovascular disease, chronic lung disease, renal and hepatic insufficiency, thyroid disorders, and use of medications that affect heart rate and cardiac electrical conduction	Not informed
Bogdan et al.,³¹	Romania, 2024	Case-control	Controle	70	26,7 ± 3,9	-21,91 ± 1,82		Not informed

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