Cardiac Adaptation of the Maternal Heart During Pregnancy: A Color-Coded Tissue Doppler Imaging Study – Feasibility, Reproducibility and Course during Pregnancy

Abstract

Alterations in tissue velocities during pregnancy reflect maturational changes that mimic "diastolic dysfunction". Based on an understanding of those normal physiological changes, TDI may therefore assist in the monitoring and/or detecting of subclinical myocardial dysfunction during pregnancy.

Cardiac adaption during pregnancy in women with congenital heart disease and healthy women

“…Ducas described an enlargement of the RVEDD during pregnancy in healthy women, which is comparable with our results in women with CHD 15. Vogt et al 14 were the first to report on systolic tissue velocities of the right ventricle (S′) during pregnancy in healthy women and did not find a significant change in systolic velocity comparing the first with the third trimester. Ducas et al 15 described, in a study using MRI, no change in TAPSE and systolic myocardial velocity of the right ventricle lateral wall in healthy pregnant women during the third trimester compared with postpartum values (which were used as baseline measurement).…”

“…Most of the available research focuses on left ventricular (LV) parameters 13. Data examining longitudinal changes in right ventricular (RV) function and dimension are scarce in healthy pregnant women and have never been reported in pregnant women with CHD 14 15…”

Evaluation of Left Atrial Functions by 2‐dimensional Speckle‐Tracking Echocardiography During Healthy Pregnancy

“…Pregnancy provides a unique model to study the adaptation of the heart in a physiologic condition of transient load changes . Moreover, the characterization and understanding of maternal cardiac functions during normal pregnancy is clinically important in terms of cardiac pathophysiology because nonobstetric mortality in pregnancy is based on cardiac diseases . Although cardiac output tends to increase gradually, peripheral vascular resistance decreases inversely.…”

“…20,21 Moreover, the characterization and understanding of maternal cardiac functions during normal pregnancy is clinically important in terms of cardiac pathophysiology because nonobstetric mortality in pregnancy is based on cardiac diseases. 22 Although cardiac output tends to increase gradually, peripheral vascular resistance decreases inversely. During normal pregnancy, an increased preload, a decreased afterload, LV remodeling, and elevation of the heart rate are seen.…”

Color Tissue Doppler to Analyze Fetal Cardiac Time Intervals: Normal Values and Influence of Sample Gate Size

“…In adult echocardiography, tissue Doppler imaging (TDI) has emerged as an adjunct to routine echocardiography that analyzes myocardial performance directly [5]. During pregnancy, TDI can detect alterations in maternal tissue velocities that reflect maturational myocardial changes [6] and is also useful in the early identification of subtle fetal cardiac dysfunction in preclinical stages [7]. TDI derives measurements of contraction and relaxation velocities from the fetal myocardium and can be used for the quantitative assessment of systolic and diastolic ventricular function [8].…”