Structural and functional changes in maternal left ventricle during pregnancy: a three-dimensional speckle-tracking...

Area of Science:

• Cardiology
• Maternal-Fetal Medicine
• Medical Imaging

Background:

• Pregnancy induces physiological adaptations in the maternal heart.
• Understanding left ventricle (LV) performance during pregnancy is crucial for maternal health.
• Transient load changes impact cardiac function during gestation.

Purpose of the Study:

• To investigate maternal LV performance during normal pregnancy.
• To assess changes in 3D speckle-tracking echocardiography (3D STE) parameters.
• To correlate LV function with loading and shape during gestation.

Main Methods:

• Sequential 2D echocardiography and 3D STE were performed on 68 pregnant women and 30 controls.
• Measurements included global longitudinal strain (GLS), global circumferential strain (GCS), global area strain (GAS), and global radial strain (GRS).
• Data were collected during each trimester and postpartum.

Main Results:

• Increased cardiac index and eccentric hypertrophy were observed, recovering postpartum.
• In late pregnancy, GLS, GCS, GAS, and GRS decreased significantly, with a slight LV ejection fraction reduction.
• 3D strain indices correlated with gestational age, with GAS showing strong associations with 3D EF and sphericity.

Conclusions:

• This study provides normal ranges for 3D STE indices in pregnancy.
• 3D STE reveals modified myocardial deformation during gestation.
• Maternal LV structure and function undergo significant changes throughout pregnancy.