Pregnancy and Heart Disease

Werkö, Lars

doi:10.3109/00016345409157601

Cited by 42 publications

(7 citation statements)

References 25 publications

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“…The only circumstances in which the cardiac output changes could be related to alterations in plasma volume would be if prior to term a significant redistribution of blood took place, with pooling of blood in the dependent venous beds and decreased venous return to the heart. Such a decrease has been reported to take place in the last month of gestation (13). At this time, elevation of venous pressure in the lower extremities without a concomitant rise in the upper extremities has also been reported (34).…”

Section: Pressuresmentioning

confidence: 87%

“…The technical methods employed in earlier cardiac catheterization studies (9, 10) make the interpretation of the cardiac output data difficult (13). In Werko, Bucht, Lagerlof, and Holmgren's studies (11,13) Three possible mechanisms may be invoked to account for the alterations in cardiac output during pregnancy. These are: 1) Increased metabolic demands of pregnancy; 2) hemodynamic effects of hypervolemia; and 3) circulatory adjustments secondary to an arterio-venous shuntlike effect of the placental circulation.…”

Section: Pressuresmentioning

confidence: 99%

“…Use of the dye dilution method for determination of cardiac output has also demonstrated the changes in cardiac output noted above (19). The technical methods employed in earlier cardiac catheterization studies (9, 10) make the interpretation of the cardiac output data difficult (13). In Werko, Bucht, Lagerlof, and Holmgren's studies (11,13) Three possible mechanisms may be invoked to account for the alterations in cardiac output during pregnancy.…”

Section: Pressuresmentioning

confidence: 99%

“…Values for arterial oxygen content were assumed, thus making the A-V oxygen difference an approximation. Werko, Bucht, Lagerlof, and Holmgren's (11,13) careful studies did not include any observations on normal pregnant women in the mid-trimester.…”

mentioning

confidence: 99%

“…Data obtained in this manner indicated that the cardiac output increased during gestation. In general, the limitations of the gas methods for determination of cardiac output (8), i.e., their relative inaccuracy, particularly in application to exercise studies, and the inability to obtain simultaneous measurements of pressures in the right side of the heart and pulmonary artery, led to several investigations of the cardiac hemodynamics utsing the catheter technique (9)(10)(11)(12)(13).…”

mentioning

confidence: 99%

See 4 more Smart Citations

Hemodynamics at Rest and During Exercise in Normal Pregnancy as Studied by Cardiac Catheterization 12

Bader¹,

Bader²,

Rose³

et al. 1955

J. Clin. Invest.

245

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Section: Pressuresmentioning

confidence: 87%

Section: Pressuresmentioning

confidence: 99%

Section: Pressuresmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Hemodynamics at Rest and During Exercise in Normal Pregnancy as Studied by Cardiac Catheterization 12

Bader¹,

Bader²,

Rose³

et al. 1955

J. Clin. Invest.

245

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Pregnancy‐Induced Physiologic Alterations

Norwitz

Robinson

2004

Critical Care Obstetrics

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Influence of Changes in Physiology, Transporters, and Enzyme Expression on Disposition and Metabolism of Drugs during Pregnancy and Clinical Implications

Jhajra

Singh

Holm³

et al. 2012

Encyclopedia of Drug Metabolism and Interactions

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Safe and effective administration of drugs during pregnancy is a challenge due to physiological changes in the mother and limited development of the mechanisms of metabolism of xenobiotics in the fetus. In particular, concentrations of transporters such as PgP, BCRP, MRP3, OCT3, and OCTN1 change in the mother's placenta and fetal tissues with advancing gestation, confounding standard therapies. Drug‐metabolizing enzymes in the placenta and developing fetus differ from those in the liver of the mother. For example, CYP3A7 is the predominant CYP3A isoform in the fetus, while CYP3A4 is predominant in adults. These isoforms have different substrates and kinetics, and thus, challenges to the fetus can be very different. Hence, there is a need for selectivity in administration of drugs and for titrating the dose to maintain efficacy and/or minimize side effects during pregnancy. This is particularly important for drugs with a narrow therapeutic window or those with marked pharmacologic or toxicological outcomes, and also for drugs that are metabolized predominantly by a single enzyme or transporter. Before initiating any new drug regimen during pregnancy, there is the need for systemic monitoring of plasma concentrations for exposure, especially during the initial days of therapy. It is anticipated that with the advancement of understanding of drug metabolism and transport in the placenta and fetus, the potential for making early predictions with respect to effect and tolerance of drugs may be possible, resulting in safer drug therapies for both pregnant mothers and fetus.

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Pregnancy and Heart Disease

Cited by 42 publications

References 25 publications

Hemodynamics at Rest and During Exercise in Normal Pregnancy as Studied by Cardiac Catheterization 12

Hemodynamics at Rest and During Exercise in Normal Pregnancy as Studied by Cardiac Catheterization 12

Pregnancy‐Induced Physiologic Alterations

Influence of Changes in Physiology, Transporters, and Enzyme Expression on Disposition and Metabolism of Drugs during Pregnancy and Clinical Implications

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