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Effects of gestational hypertension on left ventricular geometry
Ibrahim Demir1, Hüseyin Yilmaz, Ibrahim Basarici
1Akdeniz Universitesi Tip Fakültesi, Department of Cardiology, Mediterranean University, Antalya, Turkey.
Background:
During pregnancy heart rate, stroke volume, cardiac output and left ventricular (LV) mass increase while peripheral vascular resistance decreases. Gestational hypertension (GHT) which is noted in some pregnancies during the third trimester, is considered a temporary condition. Its effects on LV geometry are not known.
Aim:
To assess the effects of acute pressure overload in GHT on the LV geometry.
Methods:
Forty three pregnant women (mean age 28.7+/-8.9 years) with GHT were included in the study (Group A). Blood pressure levels >140/90 mmHg were considered diagnostic for GHT. Fifty six pregnant women (mean age 25.7+/-5.7 years) with normal blood pressure formed the control group (Group B). Transthoracic echocardiography was performed in all subjects before delivery. LV end-systolic (ESD) and end-diastolic (EDD) diameters, LV septal and posterior wall thickness were measured, and LV mass index (MI) as well as relative wall thickness (RWT) were calculated using Devereux and Ganau formulas. LV geometry was defined as normal (N), concentric hypertrophic (CH), eccentric hypertrophic (EH) or concentric remodelling (CR).
Results:
LVMI and RWT were 138+/-13.8 g/m2 and 0.46+/-0.09 in Group A, and 117+/-15 g/m2 and 0.4+/-0.03 in Group B (p=0.01 and p=0.03). LV geometry patterns were: 38.9% - N, 19.4% - EH, 14% - CH and 27.7% - CR in group A and 78.6% - N, 7% - EH, 5.4% - CH and 9% - CR in normotensive pregnancies (p<0.001).
Conclusions:
These findings suggest that LVMI and RWT are greater in GHT compared to normotensive pregnant women. Most frequently observed abnormal geometric patterns are EH and CR.