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IRB No. 22-144-1 (Dr. Agnes Kim, PI): Echocardiographic Assessment of Pulmonary Artery Pressures

Pulmonary hypertension (PHT) is a complex and challenging hemodynamic condition which is characterized by pathologic increase in mean Pulmonary Arterial Pressure (mPAP) >20 mm of Hg at rest.1 The elevated pulmonary pressures could be due to a variety of underlying causes such as lung disease, left heart disease or disease affecting small pulmonary vessels. The gold standard for a definitive diagnosis of PHT is a right heart catheterization (RHC), done invasively to assess filling pressures.2 Nevertheless, immense improvement in the technology over last few decades has made the noninvasive quantification of pulmonary pressures with increased sensitivity possible by transthoracic echocardiography (TTE).2 Echocardiography, is currently the first imaging modality in patients where PHT is suspected. It not only estimates the systolic pulmonary arterial pressures, but also provides useful information on right ventricle function, left ventricle systolic and diastolic function, as well as valvular disease that might be contributing the elevated pulmonary pressures.3 The goal is to assess the accuracy of mPAP calculated through echocardiographic assessment of PVAT and mPAP obtained through RHC.

IRB No. 23-113-2 (Dr. Andrea Shields, PI): Assessing postpartum volume status using clinical, laboratory, and sonographic values in a cohort of normotensive versus preeclamptic women

The hypothesis of this study is that ultrasound measurements of vein diameter will correlate to clinical and laboratory based values that measure the amount of fluid in a person's circulation and body; we will specifically look at women who are postpartum in two groups -- women with no high blood pressure and women with preeclampsia. Our aims will be to: - Measure the diameter of the inferior vena cava with a portable ultrasound - Examine the patient and look for signs of volume status (i.e. swelling in the legs) - Perform routine labatory tests that will reflect the amount of circulating blood volume (brain natriuretic peptide) Our objectives will be to: - Examine whether the vein diameter correlated with the level of brain natriuretic peptide - Examine whether there are differences in all values collected between the no high blood pressurs vs. preeclampsia population - In the preeclamptic population, collect 2-3 days of data so changes that occur longitudinally can also be examined.

IRB No. 24-132-2 (Dr. Tarunya Vedere, PI): Primary Hyperaldosteronism is a Risk Factor for Developing Hypertensive Disorders of Pregnancy

This research is being done to determine if Primary Hyperaldosteronism (PA) is a pre-pregnancy risk factor for Hypertensive Disorders of Pregnancy (HDP). HDP which includes preeclampsia, eclampsia, gestational hypertension and chronic hypertension complicating pregnancy occur in about 10% of pregnancies and can cause a lifetime risk of developing chronic hypertension and heart disease. This study will look to see if excessive aldosterone hormone levels might be a risk factor for that. Aldosterone is a hormone naturally made in the body that helps keep the water and salt ratios in the body balanced. Excessive aldosterone hormone levels, or PA is a well-recognized cause of hypertension. Patients may be enrolled into the study or control group. Study group patients will have had a previous diagnosis of HDP in a pregnancy no earlier than January 1, 2018. Control group patients do not have any previous HDP diagnoses. Both groups will provide a one time blood draw, providing approximately 1 tablespoon of blood to be tested as well as one urine sample.