Document Detail


Altered left ventricular contractility and function during normal pregnancy.
MedLine Citation:
PMID:  23001841     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objectives: During pregnancy, the cardiovascular system adapts to the metabolic needs of mother and fetus. The effects of this adaptation on left ventricular (LV) function have not been well documented. The aim of this study was to evaluate LV systolic and diastolic function during normal pregnancy by non-invasive measures of LV contractility incorporating loading conditions. Methods: 65 women, aged (mean ± SD) 32.0 ± 4.6 years, were studied with echocardiography including tissue Doppler and 2D speckle tracking strain, and subclavian arterial pulse trace, at gestational weeks 14-16, 22-24, 36, and 6 months postpartum. Results: Cardiac output (CO) and LV end-diastolic volume increased by 20% and 23%, (both p<0.01) compared to 6 months postpartum. LV ejection fraction (EF), global peak systolic strain (GS), and rate corrected LV velocity of circumferential fiber shortening (Vcfc) were reduced by 11%, 6%, and 6% (all p<0.01). Afterload, measured as LV end-systolic wall stress (ESWS) increased by 12% (p<0.01). By analysis of the relationship between Vcfc and ESWS, LV contractility was lower during pregnancy than 6 months postpartum. Diastolic function was demonstrated by reduction in mitral early diastolic (E) wave, decreased Tissue Doppler Early diastolic velocity (e') and increased left atrial area by 11%, 8% and 13% (all p<0.01). Tissue Doppler E/e' remained unaltered (p=0.78). Conclusions: During normal pregnancies, LV contractility is lower than 6 months postpartum. This is associated with increased LV and left atrial area, whereas filling pressures are unchanged. These findings suggest that pregnancy represents a larger load on the cardiovascular system than previously assumed. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.
Authors:
Mette-Elise Estensen; Jan Otto Beitnes; Guro Grindheim; Lars Aaberge; Otto A Smiseth; Tore Henriksen; Svend Aakhus
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-24
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  -     ISSN:  1469-0705     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.
Affiliation:
National Resource Centre for Women's Health, Oslo University Hospital, Rikshospitalet, Norway; Department of Cardiology, Oslo University Hospital, Rikshospitalet, Norway.
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