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Cardiac performance during pregnancy: serial evaluation using external systolic time intervals.

P R Liebson, L I Mann, M I Evans

    American Journal of Obstetrics and Gynecology
    |May 1, 1975
    PubMed
    Summary
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    This study shows that indirect systolic time intervals can track changes in left ventricular function during pregnancy in both normal and cardiac patients. These cardiac function changes may persist postpartum, indicating lasting effects on the heart.

    Area of Science:

    • Cardiology
    • Physiology
    • Obstetrics

    Background:

    • Pregnancy significantly alters cardiovascular function.
    • Assessing left ventricular function noninvasively during pregnancy is crucial.
    • Compensated cardiac conditions require careful monitoring during gestation.

    Purpose of the Study:

    • To evaluate serial changes in left ventricular function during pregnancy using indirect systolic time intervals.
    • To compare cardiac function changes between normal pregnant women and those with compensated cardiac conditions.
    • To determine if these cardiac changes persist postpartum.

    Main Methods:

    • Utilized indirect systolic time indices (LVET index, PEP index, PEP/LVET ratio, Q-S2 index).
    • Monitored 13 normal pregnant patients and 5 with compensated cardiac conditions.

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  • Conducted serial evaluations throughout pregnancy and into the postpartum period.
  • Main Results:

    • Both groups showed parallel changes: decreased LVET index, increased PEP index, and increased PEP/LVET ratio.
    • Q-S2 index decreased in normal pregnancy but was inconsistent in cardiac patients.
    • Systolic time intervals normalized by postpartum, but PEP and PEP/LVET remained elevated.
    • No significant intergroup differences were observed between normal and cardiac groups.

    Conclusions:

    • Indirect systolic time intervals offer a noninvasive method to assess cardiac function changes during pregnancy.
    • Observed changes suggest alterations in left ventricular contractility, preload, or afterload.
    • Persistent elevations in some indices postpartum indicate potential residual changes in intrinsic left ventricular function.
    • In compensated heart disease, indirect tests generally mirror changes seen in normal pregnancy.