期刊
CLINICAL SCIENCE
卷 116, 期 7-8, 页码 599-606出版社
PORTLAND PRESS LTD
DOI: 10.1042/CS20080142
关键词
cardiac output; cardiovascular physiology; echocardiography; pregnancy; tissue Doppler imaging
资金
- Australian Postgraduate Award
- National Health and Medical Research Council Postgraduate Medical Scholarship [359320]
- Royal Melbourne Hospital Victor Hurley Research Fund
The aim of the present study was to undertake a longitudinal study of systolic and diastolic cardiac function during normal pregnancy. At a median of 16 weeks of gestation, 100 primiparous women underwent echocardiography, including tissue Doppler imaging, determining left ventricular mass, cardiac output, systolic and diastolic velocities, and wall stress. A total of 32 were assessed again at a median of 37 weeks of gestation. Non-pregnant control estimates (n = 9) were obtained by averaging four separate measures over two menstrual cycles. Initially, the pregnant women had significantly higher pulse rates than controls, associated with greater ventricular wall stress (two-tailed P value = 0.015), and systolic (two-tailed P value = 0.005) and diastolic (two-tailed P value = 0.018) lateral wall myocardial velocities, but no differences in systolic blood pressure, left ventricular mass or cardiac output. By 37 weeks of gestation, increased blood pressure (two-tailed P value < 0.001) and left ventricular mass (two-tailed P value = 0.002) were associated with a significant increase in ventricular wall stress (two-tailed P value < 0.001), and reductions in septal systolic (two-tailed P value = 0.004) and septal and lateral early diastolic (two-tailed P value < 0.001) myocardial velocities. The diastolic velocities at 37 weeks correlated inversely with maternal weight and age. In conclusion, by term pregnancy, an increase in ventricular wall stress is accompanied by a deterioration in cardiac function.
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