在正常怀孕中对心肌适应的基于应变的心声评估:对生理重塑的洞察力
Seda Tanyeri Uzel1, Barkın Kültürsay2, Murat Karaçam3
1Department of Cardiology, Kartal Kosuyolu Training and Research Hospital, Istanbul, Türkiye.
概括
怀孕导致心脏功能和变形的持久变化,在健康妇女中产后恢复不完全. 先进的心声回声学可以帮助监测这些适应.
科学领域:
- 心脏病学 心脏病学
- 产科 产科 产科 产科 产科
- 生理学 生理学 生理学
背景情况:
- 怀孕诱导了显著的心血管适应.
- 了解怀孕期间和之后心脏功能的纵向变化对于母亲的健康至关重要.
- 心肌机械的亚临床变化甚至在健康的怀孕中也可能发生.
研究的目的:
- 在怀孕和产后早期期间调查双心室透气功能的纵向变化和心肌变形.
- 通过使用先进的心声回声技术来评估心脏适应,例如组织多普勒成像 (TDI) 和斑点追踪心声回声 (STE).
主要方法:
- 对65名健康孕妇进行前性观察性研究.
- 心声成像在四个时间点进行:第一,第二和第三季度,以及产后早期 (6-12周).
- 综合评估包括传统的多普勒,TDI,STE,纵向应变率,心房应变和左心室 (LV) 扭曲力学.
主要成果:
- 怀孕导致心脏输出量增加和心室体积增加,腹透指数和心房功能下降.
- 左心室喷射分数保持不变,但早期的透缩应变率,侧面的EM速度和全球LV扭曲率减少.
- 中心E/A比率下降,减速时间在分娩后持续时间长,心房张力呈现不完全正常化,表明异质恢复.
结论:
- 怀孕引起的心肌适应包括渐进的透析和变形变化,这些变化可能会在分娩后持续存在.
- 其余的亚临床变化表明纵向监测的价值,即使在低风险人群.
- 先进的心声回声学模式可以帮助早期检测和风险分层化与怀孕有关的心脏适应.
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