{"id":"6e3c073ef0ec","type":"article","url":"https://hartvaat.nl/2026/12/31/lvh-voorspelt-ongunstige-moeder-en-foetale-uitkomsten-bij-chronische-hypertensie/","title":"LVH voorspelt ongunstige moeder- en foetale uitkomsten bij chronische hypertensie in de zwangerschap","title_en":"Left ventricular hypertrophy as a predictor of adverse maternal and neonatal outcomes in chronic hypertension in pregnancy: a multicenter study.","category":"hypertensie","category_label":"Hypertensie","professions":["cardioloog"],"tags":[],"journal":"Hypertension in pregnancy","doi":"10.1080/10641955.2026.2719498","source_url":"https://doi.org/10.1080/10641955.2026.2719498","authors":["Bei Zhang","Guilong Pan","Wei Wang","Kai Zhang","Xiao Song","Wei Tian","Ran Chu","Shuyi Li","Hui An","Shuo Zhang"],"significance":5,"published":"2026-08-31","source_date":"2026-12-31","image":"","kennis":["https://hartvaat.nl/kennis/hypertensie/hypertensie-en-zwangerschap/","https://hartvaat.nl/kennis/hypertensie/eindorgaanschade-hypertensie/"],"congress":"","summary_en":"A multicenter retrospective cohort study (n=500) demonstrates that left ventricular hypertrophy (LVH) in women with chronic hypertension during pregnancy is independently associated with higher risks of adverse maternal (OR 2.16) and fetal/neonatal (OR 2.42) outcomes. Additional predictors included NYHA class III–IV, pre-eclampsia, and oligohydramnios. These findings support early-pregnancy echocardiography for improved risk stratification, though prospective external validation is needed before clinical implementation.","created":"2026-08-25T00:45:41Z","updated":"2026-08-25T00:45:41Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Een multicenter retrospectief cohortonderzoek (n=500) toont aan dat linkerventrikelhypertrofie (LVH) bij vrouwen met chronische hypertensie tijdens de zwangerschap onafhankelijk samenhangt met een verhoogd risico op ongunstige moeder- en foetale uitkomsten (respectievelijk OR 2,16 en OR 2,42). Naast LVH waren ook NYHA-klasse III-IV, pre-eclampsie en oligohydramnios belangrijke voorspellers. De bevindingen ondersteunen het gebruik van echocardiografie voor risicostratificatie in het eerste trimester, hoewel prospectieve validatie nog nodig is voordat de modellen routinematig worden toegepast.","abstract_original":"OBJECTIVE: The impact of chronic hypertension (CHTN) combined with left ventricular hypertrophy (LVH) on adverse maternal and fetal pregnancy outcomes remains unclear. METHODS: This multicenter retrospective cohort study included pregnant women with CHTN from four tertiary hospitals in China. Baseline characteristics were compared using the Kruskal-Wallis and Chi-squared tests with Bonferroni correction. Logistic regression (LR) identified risk factors for adverse outcomes. Four machine learning (ML) algorithms were validated, nomograms were developed for model visualization, and SHapley Additive exPlanations (SHAP) determined variable importance. RESULTS: Among 500 women, 117 (23.4%) had normal geometry, 118 (23.6%) concentric remodeling, 88 (17.6%) eccentric hypertrophy, and 177 (35.4%) concentric hypertrophy. Adverse maternal and fetal outcomes occurred in 126 (25.2%) and 359 (71.8%) women, respectively. LVH was independently associated with adverse maternal outcomes (OR 2.16, 95% CI 1.13-4.13) and fetal outcomes (OR 2.42, 95% CI 1.31-4.45). Additional maternal predictors included NYHA class III-IV, pre-eclampsia, oligohydramnios, elevated alanine aminotransferase and lactate dehydrogenase, hypoalbuminemia, greater bleeding loss, and blood transfusion. Fetal predictors included increased posterior wall thickness, oligohydramnios, abnormal umbilical artery flow, elevated alanine aminotransferase and blood urea nitrogen, low total protein, and proteinuria. ML models showed AUCs of 0.70-0.87 for maternal and 0.80-0.88 for fetal outcomes; SHAP identified LVH as an important contributor in both models. CONCLUSION: Early-pregnancy LVH was associated with higher risks of adverse maternal and fetal outcomes in women with CHTN. These models may support individualized risk stratification but require prospective external validation before clinical implementation."}