Left Ventricular Hypertrophy and Diastolic Dysfunction in Healthy Pregnant Women

Schannwell, C. M.; Zimmermann, Tobias; Schneppenheim, M.; Plehn, Gunnar; Marx, R.; Strauer, Bodo E.

doi:10.1159/000057675

Cited by 102 publications

(77 citation statements)

References 18 publications

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“…As a consequence, the left ventricular response begins with an increase in heart rate which starts as early as from 1 st trimester, further increases during 2 nd trimester which is due to increase in venous return in spite of unchanged left ventricular ejection fraction during the entire course of pregnancy. 8,9 The present study strongly supports the above fact where higher heart rate values was observed in 2 nd and 3 rd trimesters of pregnancy when compared to control, which was statistically significant. Previous ECG studies have revealed widening of QRS complex, prominent S-wave in lead I and conspicuous Q-wave and inverted T-wave in lead III during pregnancy.…”

Section: Discussionsupporting

confidence: 90%

A Comparative Study of Echocardiographic Parameters in Indian Pregnant and Nonpregnant Women

Bhattacharyya¹,

Balasubiramaniyan²

2017

jemds

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BACKGROUNDPregnancy is a physiological stressful condition, which is accompanied by changes in cardiovascular parameters to fulfil the requirement of rapidly developing embryo and subsequent foetal growth. Serial evaluation has demonstrated noticeable changes in echocardiographic variables due to haemodynamic overload. Hence, it was proposed to estimate the degree of cardiovascular alteration during pregnancy in South Indian women.

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Section: Discussionsupporting

confidence: 90%

A Comparative Study of Echocardiographic Parameters in Indian Pregnant and Nonpregnant Women

Bhattacharyya¹,

Balasubiramaniyan²

2017

jemds

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“…The volume-overloaded state (with increased preload) of pregnancy causes physiological LVH;17 after the first pregnancy, subsequent pregnancies have been shown to enhance this 16. Similarly, as mentioned, the expected pregnancy-associated ST-segment sagging depressed the ‘Negroid pattern’ ST-segment elevation to the isoelectric line.…”

Section: Discussionmentioning

confidence: 89%

Cardiovascular and electrocardiographic changes in Nigerians with a normal pregnancy

Akinwusi¹,

Oboro²,

Adebayo³

et al. 2011

CardioVascular Journal of Africa

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IntroductionPregnancy is associated with major haemodynamic and cardiac changes, which can mimic or precipitate cardiac diseases. There is a paucity of this kind of data among pregnant Nigerian women. This study was aimed at describing the cardiovascular and electrocardiographic changes found among healthy pregnant Nigerian women.MethodsThis was an age-matched control study of 69 consecutive normal pregnant and 70 healthy non-pregnant controls. The study protocol included history, physical examination and 12-lead electrocardiography.ResultsDiastolic blood pressure < 60 mmHg was significantly commoner among pregnant subjects than controls (64.7 vs 24.3%, respectively, p < 0.005). Mean heart rate was higher among pregnant women (88.34 ± 11.46 bpm) than the controls (75.16 ± 12.22 bpm, p = 0.020). Pregnant subjects also had a higher proportion of left ventricular hypertrophy (LVH) (10.2 vs 0%, p < 0.05) than non-pregnant controls. Abnormal cardiac findings included a loud second heart sound (P2), missed beats and systolic murmurs (41.2% in pregnant subjects vs 12.9% in non-pregnant controls, p < 0.05). Negroid-pattern ST-segment elevation was commoner among controls (24.3%) than pregnant subjects (2.9%, p < 0.005). Arrhythmias were rare among the study participants.ConclusionSignificant findings on examination were low diastolic blood pressure and a systolic ejection murmur. However, ECG changes showed a normal frontal-plane QRS axis, normal PR interval, significantly rare normal Negroidpattern ST elevation, significant LVH based on Araoye RI > 12 mm and a rarity of all forms of arrhythmias. These data may help resolve some cardiac diagnostic difficulties during pregnancy.

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“…Although a cardiac output increase of different magnitude paralleled by a peripheral vascular resistance decrease has been well documented, [2][3][4][5][6][7][8][9][10][11][12] reports on cavity dimensions, mass, and volumes are inconsistent. [3][4][5][6][7][8][9][10][11][12] Likewise, myocardial function has been described as normal, depressed, or enhanced. 4,8 -13 Part of the differences might be explained by the different formulas used for deriving ejection fraction (EF).…”

Section: Editorial See P 283 Clinical Perspective On P 297mentioning

confidence: 99%

Morphological and Functional Adaptation of the Maternal Heart During Pregnancy

Savu

Jurcuţ

Giuşcă

et al. 2012

Circ: Cardiovascular Imaging

241

161

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Background-Pregnancy provides a unique model to study the adaptation of the heart in a physiological situation of transient load changes. The aim of this study was to assess the performance of the left ventricle (LV) in normal, uncomplicated pregnancies while considering the actual LV load and shape. Methods and Results-Serial echocardiographic examinations were performed in 51 women in each pregnancy trimester and 3 to 6 months after delivery. Data from 10 nulliparous, age-matched women were used as the control. Conventional parameters of LV function (ejection fraction) as well as myocardial deformation (strain) were interpreted, taking into consideration maternal hemodynamics and LV shape. Cardiac output increased during pregnancy because of a higher stroke volume in early pregnancy and a late increase in heart rate, whereas total vascular resistance decreased. Progressive development of eccentric hypertrophy was observed, which subsequently recovered postpartum. Sphericity index decreased from the first to the third trimester (1.92Ϯ0.17 versus 1.71Ϯ0.17) and returned postpartum to values comparable to the control. Although higher LV stroke work was noted toward the third trimester (5.9Ϯ1.1 versus 5.3Ϯ1.0 Newton meter, PϽ0.001), ejection fraction showed no significant changes. LV strain decreased significantly in late pregnancy (Ϫ19.5Ϯ2% to Ϫ17.6Ϯ1.6%, PϽ0.001) and returned to baseline values after delivery (Ϫ19.5Ϯ2%). Conclusions-Pregnancy is a physiological process associated with increased cardiac performance and progressive LV remodeling. These changes are not directly reflected by parameters traditionally considered to describe systolic function, such as ejection fraction and longitudinal deformation. While ejection fraction was insensitive to the functional changes, the transient decrease in longitudinal deformation becomes only plausible when considering the changes in LV geometry. (Circ Cardiovasc Imaging. 2012;5:289-297.)

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Left Ventricular Hypertrophy and Diastolic Dysfunction in Healthy Pregnant Women

Cited by 102 publications

References 18 publications

A Comparative Study of Echocardiographic Parameters in Indian Pregnant and Nonpregnant Women

A Comparative Study of Echocardiographic Parameters in Indian Pregnant and Nonpregnant Women

Cardiovascular and electrocardiographic changes in Nigerians with a normal pregnancy

Morphological and Functional Adaptation of the Maternal Heart During Pregnancy

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