Cardiovascular adaptation during pregnancy may be altered in women with autoimmune diseases. A quantitative echocardiographic study published in the Frontiers in Cardiovascular Medicine assessed left ventricular (LV) myocardial work (MW) parameters using pressure–strain loop (PSL) analysis to evaluate myocardial performance in pregnant women with autoimmune diseases.

The study enrolled 96 participants between September 2020 and September 2022 at the Affiliated Hospital of Inner Mongolia Medical University. Participants were categorized into three groups: 33 pregnant women with autoimmune diseases (AD-P group), 26 non-pregnant patients with autoimmune diseases (AD group), and 37 healthy pregnant women (H-P group). Clinical data were collected alongside conventional echocardiography, two-dimensional speckle-tracking imaging, and LV myocardial work assessments.
After adjustment for baseline characteristics, the AD-P group showed increased LV volumes and lower apical constructive work (apical-CW) compared with the non-pregnant AD group, although global MW indices were similar. Compared with healthy pregnant controls, AD-P patients had lower E/A ratios, increased LV volumes, higher E/e′ values, and greater peak strain dispersion (PSD). Adjusted analyses demonstrated that AD-P patients had reduced global work index (GWI), global constructive work (GCW), and global work efficiency (GWE), while PSD remained higher than in the H-P group.

Apical constructive work showed a consistent reduction in pregnant women with autoimmune disease.

LV myocardial work analysis was associated with markers of subclinical LV dysfunction in pregnancies complicated by autoimmune disease. Apical constructive work showed a consistent reduction and may offer additional information, alongside global longitudinal strain, when evaluating myocardial performance during pregnancy.