Document Detail

Hemodynamic adaptation to pregnancy in women with structural heart disease.
MedLine Citation:
PMID:  23151412     Owner:  NLM     Status:  Publisher    
BACKGROUND: Many women with structural heart disease reach reproductive age and contemplate motherhood. Pregnancy induces and requires major hemodynamic changes. Pregnant women with structural heart disease may have a reduced cardiac reserve. There are no longitudinal data on cardiovascular adaptation throughout pregnancy in women with structural heart disease. METHODS: Thirty-five women with structural heart disease were included in a prospective observational trial. Maternal hemodynamics were assessed before conception, during pregnancy and 6months postpartum by transthoracic echocardiography. Uteroplacental perfusion was analyzed by obstetric Dopplers. Longitudinal evolution over time was analyzed as well as the long term influence of pregnancy on cardiac function. RESULTS: Cardiac output (CO), stroke volume (SV), left ventricular mass (LV mass) and E/E' ratio significantly increased and ejection fraction (EF) and fractional shortening (FS) decreased during pregnancy. There was a statistically significant difference in EF, FS and E/E' ratio before and after pregnancy. CONCLUSIONS: The characteristic pattern of hemodynamic adaptation to pregnancy is attenuated in women with structural heart disease. The pregnancy related volume load induces progression of diastolic dysfunction. Our data suggest a persistent reduction in systolic and diastolic cardiac functions after pregnancy in women with structural heart disease.
J Cornette; T P E Ruys; A Rossi; D Rizopoulos; J J M Takkenberg; Y Karamermer; P Opić; A E Van den Bosch; M L Geleijnse; J J Duvekot; E A P Steegers; J W Roos-Hesselink
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-11
Journal Detail:
Title:  International journal of cardiology     Volume:  -     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Department of Obstetrics & Gynaecology, Division of Obstetrics & Prenatal Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands. Electronic address:
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