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Structural and functional changes in left ventricle during normotensive and preeclamptic pregnancy
Lisa A Simmons1, Adrian G Gillin, Richmond W Jeremy
1Department of Medicine, University of Sydney, New South Wales 2006, Australia.
American Journal of Physiology. Heart and Circulatory Physiology
|September 18, 2002
Summary
Cardiac remodeling occurs during pregnancy, but left ventricular (LV) contractility is preserved even in preeclampsia. This study compared LV function in pregnant women with and without preeclampsia to controls.
Area of Science:
- Cardiology
- Obstetrics
- Physiology
Background:
- Pregnancy increases cardiac output, leading to cardiac remodeling.
- Preeclampsia may exacerbate reductions in cardiac contractility.
- Understanding left ventricular (LV) adaptation is crucial in pregnancy.
Purpose of the Study:
- To compare LV geometry and systolic function between nonpregnant controls, normotensive pregnant women, and preeclamptic pregnant women.
- To assess load-independent measures of LV systolic function.
Main Methods:
- Echocardiography was used to evaluate LV geometry and function.
- End-systolic stress (ESS) and rate-corrected velocity of circumferential fiber shortening (V(CFC)) were calculated for load-independent comparisons.
- Mean arterial pressures were recorded.
Main Results:
- Left ventricular (LV) mass increased in normotensive pregnancy and was greater in preeclampsia compared to controls.
- Mean arterial pressure was significantly higher in preeclampsia.
- Despite increased cardiac work, LV contractility (V(CFC)) remained preserved in both normotensive and preeclamptic pregnancy, with unchanged ESS-V(CFC) relationships.
Conclusions:
- Left ventricular (LV) hypertrophy in pregnancy (both normotensive and preeclamptic) is proportional to the increased cardiac work.
- Left ventricular (LV) contractility is maintained throughout normotensive pregnancy and in preeclampsia.