{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:45:14Z","timestamp":1792788314957,"version":"4.5.0"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,3,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Preeclampsia is a prominent risk factor for long\u2010term development of cardiovascular disease. Although existing studies report a strong correlation between preeclampsia and heart failure, the underlying mechanisms are poorly understood. One possibility is the glycoprotein growth factor activin A. During pregnancy, elevated activin A levels are associated with impaired cardiac global longitudinal strain at 1 year, but whether these changes persist beyond 1 year is not known. We hypothesized that activin A levels would remain increased more than 1 year after a preeclamptic pregnancy and correlate with impaired cardiac function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      To test our hypothesis, we performed echocardiograms and measured activin A levels in women approximately 10 years after an uncomplicated pregnancy (n=25) or a pregnancy complicated by preeclampsia (n=21). Compared with women with a previously normal pregnancy, women with preeclampsia had worse global longitudinal strain (\u221218.3% versus \u221221.3%,\n                      <jats:italic>P<\/jats:italic>\n                      =0.001), left ventricular posterior wall thickness (0.91\u00a0mm versus 0.80\u00a0mm,\n                      <jats:italic>P<\/jats:italic>\n                      =0.003), and interventricular septal thickness (0.96\u00a0mm versus 0.81\u00a0mm,\n                      <jats:italic>P<\/jats:italic>\n                      =0.0002). Women with preeclampsia also had higher levels of activin A (0.52 versus 0.37\u00a0ng\/mL,\n                      <jats:italic>P<\/jats:italic>\n                      =0.02) and activin\/follistatin\u2010like 3 ratio (0.03 versus 0.02,\n                      <jats:italic>P<\/jats:italic>\n                      =0.04). In a multivariable model, the relationship between activin A levels and worsening global longitudinal strain persisted after adjusting for age at enrollment, mean arterial pressure, race, and body mass index (\n                      <jats:italic>P<\/jats:italic>\n                      =0.003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Our findings suggest that both activin A levels and global longitudinal strain are elevated 10 years after a pregnancy complicated by preeclampsia. Future studies are needed to better understand the relationship between preeclampsia, activin A, and long\u2010term cardiac function.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.120.018526","type":"journal-article","created":{"date-parts":[[2021,2,23]],"date-time":"2021-02-23T05:04:01Z","timestamp":1614056641000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":39,"title":["Long\u2010Term Postpartum Cardiac Function and Its Association With Preeclampsia"],"prefix":"10.1161","volume":"10","author":[{"given":"Victoria A.","family":"deMartelly","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Chicago IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Dreixler","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Critical Care University of Chicago 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Critical Care University of Chicago IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heba","family":"Naseem","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Chicago IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Lang","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Chicago IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Kruse","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Chicago IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Yamat","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Chicago IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joey P.","family":"Granger","sequence":"additional","affiliation":[{"name":"Department of Physiology and Biophysics University of Mississippi Medical Center Jackson MS"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhavisha A.","family":"Bakrania","sequence":"additional","affiliation":[{"name":"Department of Physiology and Biophysics University of Mississippi Medical Center Jackson MS"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Rodriguez\u2010Kovacs","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Chicago IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarosh","family":"Rana","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Chicago IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7477-133X","authenticated-orcid":false,"given":"Sajid","family":"Shahul","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Critical Care University of 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