# Cardiac Manifestations of Preeclampsia

> **NIH NIH R01** · COLUMBIA UNIVERSITY HEALTH SCIENCES · 2020 · $391,191

## Abstract

Preeclampsia, a hypertensive disorder affecting 5-8% of pregnancies, is associated with life-threatening
maternal-fetal consequences and its incidence is on the rise. Long regarded as a temporary obstetrical
condition with implications limited to pregnancy, it is now recognized that women with prior preeclampsia are at
elevated risk for the development of sustained hypertension, premature cardiovascular disease (CVD) and a
shortened lifespan. The pathophysiology of preeclampsia includes excessive placental release of anti-
angiogenic proteins that lead to systemic manifestations of hypertension, proteinuria, and endothelial
dysfunction. Preeclampsia is also associated with left ventricular (LV) hypertrophy and abnormal LV function,
and growing body of evidence suggests that the cardiovascular abnormalities persist beyond the peripartum
period. The mechanism of insult of preeclampsia’s cardiovascular effects are unknown. The central hypothesis
of this proposal is that the anti-angiogenic state induced by preeclampsia increases future CVD risk by directly
altering cardiac structure and function. We will employ state of the art cardiac magnetic resonance (CMR)
stress imaging to quantify the coronary microcirculation and to provide deep cardiac phenotyping of the
structural and functional changes after preeclampsia. We will perform a single site ancillary study in 120
women (40 with preeclampsia) followed at Columbia University in the Nulliparous Pregnancy Outcomes Study
Monitoring Mothers-to-be Heart Health Study (nuMoM2b-HHS) to pursue the following specific aims: (1) To
examine whether there are differences in the coronary microcirculation of women with a history of preeclampsia
during their nuMoM2b index pregnancy compared to control women who did not have preeclampsia; (2) To
determine the extent to which previous preeclampsia directly alters later cardiac structure by increasing LV mass
and separately fibrosis; (3) To quantify the associations between circulating anti-angiogenic proteins of pregnancy
with coronary perfusion and fibrosis 7 to 14 years after delivery. Comprehensive cardiac phenotyping of women
with and without a history of preeclampsia will inform future studies examining CVD risk stratification and
modification in women with a history of preeclampsia. Despite sharing many risk factors, including female
predominance, obesity, and hypertension, the associations of preeclampsia with coronary microvascular
disease and myocardial fibrosis have not been examined. This proposal is a crucial step towards better
understanding the mechanisms through which preeclampsia alters future CVD risk in women. This knowledge
will enable the development of novel, informed interventions to prevent or delay the incidence of CVD in
women with a history of preeclampsia thereby decreasing premature morbidity and mortality and healthcare
costs in a young and expanding subset of women.

## Key facts

- **NIH application ID:** 10029337
- **Project number:** 1R01HL153382-01
- **Recipient organization:** COLUMBIA UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** Natalie A Bello
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $391,191
- **Award type:** 1
- **Project period:** 2020-06-15 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10029337

## Citation

> US National Institutes of Health, RePORTER application 10029337, Cardiac Manifestations of Preeclampsia (1R01HL153382-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10029337. Licensed CC0.

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