Maternal cardiac systolic and diastolic function: relationship with uteroplacental resistances. A Doppler and echocardiographic longitudinal study

Valensise, H.; Novelli, G. P.; Vasapollo, B.; Borzi, Mauro; Arduini, Domenico; Galante, Alberto; Romaninï, Carlo

doi:10.1046/j.1469-0705.2000.00135.x

Cited by 98 publications

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“…In physiological pregnancies, reduction in uteroplacental resistance index, because of the remodelling of the spiral artery, is concomitant with a decrease in TVR, which represents the steady component of the afterload, and includes the uteroplacental circulation with a contribution of 20% to 26% to the total reduction of systemic vascular resistance in the second trimester. 16 Abnormal uterine artery Doppler waveforms during the second trimester of pregnancy have been linked to an altered trophoblast invasion of the spiral arteries with an abnormal placentation process and seem to be related to several disorders of pregnancy, such as FGR and preeclampsia. In the last decade, an altered cardiovascular adaptation was noted in patients with such complications.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, maternal cardiac function was studied in normal and complicated pregnancy obtaining important information on systolic and diastolic function and on morphological parameters of the left ventricle. [13][14][15][16][17][18][19][20][21][22][23] In particular total vascular resistance (TVR) was found to be an important parameter in the early identification of hypertensive patients who subsequently developed complications. 22 In our previous pilot study, 24 we observed that normotensive high-risk patients with bilateral notch of the uterine arteries who subsequently showed abnormal outcome of pregnancy had higher TVR compared with the normal-outcome group.…”

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confidence: 99%

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Total Vascular Resistance and Left Ventricular Morphology as Screening Tools for Complications in Pregnancy

Vasapollo¹,

Novelli²,

Valensise³

2008

Hypertension

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Abstract-We evaluated the predictive value of elevated total vascular resistance on the outcome of pregnancy in normotensive high-risk primigravidas with bilateral notching of the uterine artery Doppler. A total of 526 high-risk primigravidas referred to the obstetrics outpatient clinic of Tor Vergata University with bilateral notching of the uterine artery at 20 to 22 weeks' gestation were submitted to a maternal echocardiographic examination and uterine artery Doppler evaluation at 24 weeks' gestation. Blood pressure was recorded at the time of the examination, total vascular resistance was calculated, and the geometric pattern of the left ventricle was assessed. Patients were followed until the end of pregnancy to detect fetal/maternal adverse outcomes (gestational hypertension, preeclampsia, abruptio placentae, fetal growth restriction, perinatal death, etc). A total of 111 of the 526 pregnancies showed a bilateral notch at 24 weeks' gestation, and 97 had an adverse outcome (18.44%). The best independent predictor for maternal and fetal complications was total vascular resistance (odds ratio: 91.25; 95% CI: 39.64 to 210.05; PϽ0.001). The cutoff value was 1400 dynes ⅐ s ⅐ cm Ϫ5, with a sensitivity and a specificity of 89% and 94%, respectively. A high relative wall thickness of the left ventricle (Ͼ0.37; odds ratio: 2.47; 95% CI: 1.12 to 5.44) and a hypertrophized ventricle (left ventricular mass Ͼ130 g; odds ratio: 2.52; 95% CI: 1.12 to 5.64) were also independent predictors (PϽ0.05). Echocardiography might identify at 24 weeks' gestation patients who subsequently develop maternal and fetal complications through the assessment of maternal hemodynamics and left ventricular geometry. (Hypertension. 2008;51:1020-1026.)

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Total Vascular Resistance and Left Ventricular Morphology as Screening Tools for Complications in Pregnancy

Vasapollo¹,

Novelli²,

Valensise³

2008

Hypertension

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“…14,15 Although the uterine vascular bed has a specific and well-established role in the physiological adaptation of the whole maternal peripheral vasculature, 27,28 and in the genesis of hemodynamic alterations in pregnancy, this parameter does not appear to be an independent predictor when analyzed together with the cardiac parameters. In our model, concentric geometry results were the strongest independent predictor of adverse outcomes.…”

Section: Discussionmentioning

confidence: 99%

Left Ventricular Concentric Geometry as a Risk Factor in Gestational Hypertension

et al. 2003

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Abstract-In the past, an adverse prognostic significance of an altered left ventricular geometry in essential hypertension has been demonstrated. There are no data on the prognostic significance of an altered cardiac structure during pregnancy. The present study was designed to evaluate the prognostic impact on the outcome of pregnancy of an altered geometry of the left ventricle in mild gestational hypertension. One hundred forty-eight consecutive, pregnant, mild gestational hypertensive women (systolic and diastolic blood pressure, 140 to 150 mm Hg and 90 to 99 mm Hg, respectively) were included in the study. Patients were monitored until term to detect subsequent fetal and/or maternal adverse outcomes (preeclampsia, preterm delivery, abruptio placentae, other maternal medical problems, fetal distress, neonatal low birth weight, admittance to neonatal intensive care unit

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“…Physiological gestation is accompanied by significant adaptations in maternal hemodynamics, both in women and in female dogs (DUVEKOT et al, 1993) and these ensure adequate uterine perfusion and consequently normal fetal development (VALENSISE et al, 2000;BLANCO et al, 2008). Results of the hemodynamic adaptations involving the cardiovascular system in mammals are very similar (DESAI et al, 2004;BLANCO et al, 2011).…”

Section: Gestational Hemodynamicsmentioning

confidence: 99%

Hemodynamic gestational adaptation in bitches

et al. 2017

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Throughout pregnancy, maternal hemodynamic adaptation is needed to ensure proper uterine perfusion and fetal development. When the uteroplacental vascular system is formed, starting with reduced resistance to uterine arterial flow, this results in decreased total vascular resistance, an activation of neuroendocrine vasoactive peptides, an increase in circulating blood and changes in the cardiovascular system morphophysiology to respond to the increasing demands of uterine perfusion. There has been considerable study of hemodynamic adaptation in pregnant women and this assessment has become a diagnostic tool for fatal obstetric disorders. However, in bitches the available information in this regard is limited; therefore a parallel was drawn between other species of animals and women, in order to subsidize the paucity of information about this process and facilitate the understanding of maternal-fetal hemodynamic adaptation in pregnant bitches. This review and literature analysis aimed\ to discuss morphophysiological cardiovascular adaptations during pregnancy and the possible disorders that can affect this process in pregnant female dogs.

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Maternal cardiac systolic and diastolic function: relationship with uteroplacental resistances. A Doppler and echocardiographic longitudinal study

Cited by 98 publications

References 0 publications

Total Vascular Resistance and Left Ventricular Morphology as Screening Tools for Complications in Pregnancy

Total Vascular Resistance and Left Ventricular Morphology as Screening Tools for Complications in Pregnancy

Left Ventricular Concentric Geometry as a Risk Factor in Gestational Hypertension

Hemodynamic gestational adaptation in bitches

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