Background: Preeclampsia is a significant hypertensive disorder of pregnancy associated with increased maternal and fetal morbidity. Emerging evidence suggests that it is also linked with subclinical cardiovascular dysfunction, particularly diastolic abnormalities. This study aims to evaluate echocardiographic changes, especially diastolic function, in preeclamptic women using two-dimensional transthoracic echocardiography.

Objectives: To assess left ventricular function, focusing on diastolic and systolic parameters, in women with preeclampsia, and to correlate echocardiographic findings with gestational age and maternal age.

Methods: This hospital-based case-control study included 250 pregnant women between 20 and 36+6 weeks of gestation. Of these, 125 were diagnosed with preeclampsia and 125 were normotensive controls. Standard 2D echocardiography was used to assess parameters such as mitral inflow velocities, deceleration time, and E/e’ ratio. Statistical analysis was performed using SPSS version 26.0.

Results: Early-onset preeclampsia (<34 weeks) was observed in 36% of cases. Mitral valve peak E velocity was significantly lower in cases (83.37 ± 20.19 cm/s) compared to controls (101.55 ± 6.91 cm/s, p < 0.0001). Deceleration time was mildly prolonged in cases (188.12 ± 37.57 ms) but not statistically significant (p = 0.096). The E/e’ ratio was significantly lower in cases (8.23 ± 0.88 vs. 9.59 ± 1.81, p < 0.0001). Grade 1 diastolic dysfunction was present in 19.2% of preeclamptic women, with none in controls (p < 0.0001). Diastolic dysfunction was more common in the 21–30 year age group and in those with gestational age >34 weeks.

Conclusion: Preeclampsia is associated with early changes in left ventricular diastolic function, even in the absence of overt cardiac symptoms. 2D echocardiography is a valuable non-invasive tool for detecting subclinical cardiac dysfunction in these patients. Routine cardiac evaluation may aid in risk stratification and long-term cardiovascular monitoring of women with preeclampsia.