Details
| Original language | English |
|---|---|
| Pages (from-to) | 350-358 |
| Number of pages | 9 |
| Journal | Ultrasound in Obstetrics and Gynecology |
| Volume | 54 |
| Issue number | 3 |
| Publication status | Published - Sept 2019 |
| Externally published | Yes |
Abstract
Objective: To evaluate left ventricular (LV) mechanics in the second trimester of healthy pregnancy and to determine the influence of underpinning hemodynamics (heart rate (HR), preload and afterload) on LV mechanics during gestation. Methods: This was a cross-sectional study of 18 non-pregnant, 14 nulliparous pregnant (22–26 weeks' gestation) and 13 primiparous postpartum (12–16 weeks after delivery) women. All pregnant and postpartum women had uncomplicated, singleton gestations. Cardiac structure and function were assessed using echocardiography. LV mechanics, specifically longitudinal strain, circumferential strain and twist/untwist, were measured using speckle-tracking echocardiography. Differences between groups were identified using ANCOVA, with age, HR, end-diastolic volume (EDV) and systolic blood pressure (SBP) as covariates. Relationships between LV mechanics and hemodynamics were examined using Pearson's correlation. Results: There were no significant differences in LV structure and traditional measurements of systolic and diastolic function between the three groups. Pregnant women, compared with non-pregnant ones, had significantly higher resting longitudinal strain (–22 ± 2% vs –17 ± 3%; P = 0.002) and basal circumferential strain (–23 ± 4% vs –16 ± 2%; P = 0.001). Apical circumferential strain and LV twist and untwist mechanics were similar between the three groups. No statistically significant relationships were observed between LV mechanics and HR, EDV or SBP within the groups. Conclusions: Compared to the non-pregnant state, pregnant women in the second trimester of a healthy pregnancy have significantly greater resting systolic function, as assessed by LV longitudinal and circumferential strain. Contrary to previous work, these data show that healthy pregnant women should not exhibit reductions in resting systolic function between 22 and 26 weeks' gestation. The enhanced myocardial contractile function during gestation does not appear to be related to hemodynamic load and could be the result of other physiological adaptations to pregnancy.
Keywords
- echocardiography, left ventricular mechanics, maternal hemodynamics
ASJC Scopus subject areas
- Health Professions(all)
- Radiological and Ultrasound Technology
- Medicine(all)
- Reproductive Medicine
- Medicine(all)
- Radiology Nuclear Medicine and imaging
- Medicine(all)
- Obstetrics and Gynaecology
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In: Ultrasound in Obstetrics and Gynecology, Vol. 54, No. 3, 09.2019, p. 350-358.
Research output: Contribution to journal › Article › Research › peer review
}
TY - JOUR
T1 - Left ventricular mechanics in late second trimester of healthy pregnancy
AU - Meah, V. L.
AU - Backx, K.
AU - Cockcroft, J. R.
AU - Shave, R. E.
AU - Stöhr, E. J.
PY - 2019/9
Y1 - 2019/9
N2 - Objective: To evaluate left ventricular (LV) mechanics in the second trimester of healthy pregnancy and to determine the influence of underpinning hemodynamics (heart rate (HR), preload and afterload) on LV mechanics during gestation. Methods: This was a cross-sectional study of 18 non-pregnant, 14 nulliparous pregnant (22–26 weeks' gestation) and 13 primiparous postpartum (12–16 weeks after delivery) women. All pregnant and postpartum women had uncomplicated, singleton gestations. Cardiac structure and function were assessed using echocardiography. LV mechanics, specifically longitudinal strain, circumferential strain and twist/untwist, were measured using speckle-tracking echocardiography. Differences between groups were identified using ANCOVA, with age, HR, end-diastolic volume (EDV) and systolic blood pressure (SBP) as covariates. Relationships between LV mechanics and hemodynamics were examined using Pearson's correlation. Results: There were no significant differences in LV structure and traditional measurements of systolic and diastolic function between the three groups. Pregnant women, compared with non-pregnant ones, had significantly higher resting longitudinal strain (–22 ± 2% vs –17 ± 3%; P = 0.002) and basal circumferential strain (–23 ± 4% vs –16 ± 2%; P = 0.001). Apical circumferential strain and LV twist and untwist mechanics were similar between the three groups. No statistically significant relationships were observed between LV mechanics and HR, EDV or SBP within the groups. Conclusions: Compared to the non-pregnant state, pregnant women in the second trimester of a healthy pregnancy have significantly greater resting systolic function, as assessed by LV longitudinal and circumferential strain. Contrary to previous work, these data show that healthy pregnant women should not exhibit reductions in resting systolic function between 22 and 26 weeks' gestation. The enhanced myocardial contractile function during gestation does not appear to be related to hemodynamic load and could be the result of other physiological adaptations to pregnancy.
AB - Objective: To evaluate left ventricular (LV) mechanics in the second trimester of healthy pregnancy and to determine the influence of underpinning hemodynamics (heart rate (HR), preload and afterload) on LV mechanics during gestation. Methods: This was a cross-sectional study of 18 non-pregnant, 14 nulliparous pregnant (22–26 weeks' gestation) and 13 primiparous postpartum (12–16 weeks after delivery) women. All pregnant and postpartum women had uncomplicated, singleton gestations. Cardiac structure and function were assessed using echocardiography. LV mechanics, specifically longitudinal strain, circumferential strain and twist/untwist, were measured using speckle-tracking echocardiography. Differences between groups were identified using ANCOVA, with age, HR, end-diastolic volume (EDV) and systolic blood pressure (SBP) as covariates. Relationships between LV mechanics and hemodynamics were examined using Pearson's correlation. Results: There were no significant differences in LV structure and traditional measurements of systolic and diastolic function between the three groups. Pregnant women, compared with non-pregnant ones, had significantly higher resting longitudinal strain (–22 ± 2% vs –17 ± 3%; P = 0.002) and basal circumferential strain (–23 ± 4% vs –16 ± 2%; P = 0.001). Apical circumferential strain and LV twist and untwist mechanics were similar between the three groups. No statistically significant relationships were observed between LV mechanics and HR, EDV or SBP within the groups. Conclusions: Compared to the non-pregnant state, pregnant women in the second trimester of a healthy pregnancy have significantly greater resting systolic function, as assessed by LV longitudinal and circumferential strain. Contrary to previous work, these data show that healthy pregnant women should not exhibit reductions in resting systolic function between 22 and 26 weeks' gestation. The enhanced myocardial contractile function during gestation does not appear to be related to hemodynamic load and could be the result of other physiological adaptations to pregnancy.
KW - echocardiography
KW - left ventricular mechanics
KW - maternal hemodynamics
UR - http://www.scopus.com/inward/record.url?scp=85071741713&partnerID=8YFLogxK
U2 - 10.1002/uog.20177
DO - 10.1002/uog.20177
M3 - Article
C2 - 30426576
AN - SCOPUS:85071741713
VL - 54
SP - 350
EP - 358
JO - Ultrasound in Obstetrics and Gynecology
JF - Ultrasound in Obstetrics and Gynecology
SN - 0960-7692
IS - 3
ER -