title: [Vascular reactivity response to mental stress in pregnant women with mitral stenosis].
abstract: OBJECTIVE
  To study vascular reactivity according to the analysis of blood flow and peripheral vascular resistance at rest and during mental stress in pregnant women with mitral stenosis.
  
  
  METHODS
  Twenty two women with mitral stenosis, 13 of whom were pregnant (PS) and 9 were non-pregnant (MIS), and 9 healthy pregnant women (NP) were studied. During gestation, 9 out of the 13 patients of the PS group required a beta-blocker (PSB) and the remaining 4 progressed without medication (PSWB). Plethysmography at rest and during mental stress analyzed muscle blood flow, peripheral vascular resistance (PVR), mean arterial pressure (MAP) and heart rate (HR) during gestation and puerperium.
  
  
  RESULTS
  During gestation of PSWB, muscle blood flow and HR were higher in 1.6% and 20.5% (p = 0.05), and PVR and MAP were lower in 19.3% and 4.4%, respectively, in comparison to the puerperium; during mental stress, the muscle blood flow increased by 55.9%, HR decreased by 30.2% and PVR and MAP were similar. In PSB, muscle blood muscle blood flow and HR were greater in 5.9% and 14.9% (p= 0.001) and MAP and PVR were lower in 10.3% and 9.1%, respectively, when compared to the puerperium. During mental stress, muscle blood flow and MAP increased by 69.8% and 174.1%, respectively. HR was similar and PVR decreased by 53.7%. The comparative study showed that in the NP group the muscle blood flow was higher, PVR was lower, and MAP and HR were similar in relation to the PS group, and that the PS, NP, MIS groups had a similar response to mental stress.
  
  
  CONCLUSIONS
  Vascular reactivity in pregnant women with mitral stenosis was preserved and the analysis of measurements showed lower values of muscle blood flow and higher values of PVR when compared to those of healthy pregnant women.
authors.affiliation: Instituto do Coração, Hospital das Clínicas, FMUSP, São Paulo, SP, Brazil. walkiria@incor.usp.br
authors.forename: Walkiria Samuel
authors.initials: WS
authors.lastname: Avila
authors.forename: Osmar Araújo
authors.initials: OA
authors.lastname: Calil
authors.forename: Ivani C
authors.initials: IC
authors.lastname: Trombetta
authors.forename: Carlos Eduardo
authors.initials: CE
authors.lastname: Negrão
authors.forename: Max
authors.initials: M
authors.lastname: Grinberg
authors.forename: Marcelo
authors.initials: M
authors.lastname: Zugaib
authors.forename: José Antonio Franchini
authors.initials: JA
authors.lastname: Ramires
mesh_terms: D000293:Adolescent; D000328:Adult; D001783:Blood Flow Velocity; D001794:Blood Pressure; D001808:Blood Vessels / Q000378:metabolism / Q000503:physiopathology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008946:Mitral Valve Stenosis / Q000378:metabolism / Q000503:physiopathology*; D009132:Muscles / Q000098:blood supply*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000378:metabolism / Q000503:physiopathology*; D011446:Prospective Studies; D012039:Regional Blood Flow; D013315:Stress, Psychological / Q000378:metabolism / Q000503:physiopathology*; D014655:Vascular Resistance