title: Maternal left ventricular diastolic and systolic long-axis function during normal pregnancy.
abstract: OBJECTIVE
  The aim of this study was to evaluate left ventricular (LV) function during normal pregnancy and investigate the effect of maternal factors. Little information about LV diastolic and long-axis systolic function in normal pregnancy exists.
  
  
  RESULTS
  Two hundred and twenty eight Doppler echocardiography and DTI studies of the mitral annulus were performed in 63 normal pregnant women longitudinally at 11-14, 20-24, 26-32, 33-38weeks and 8-12weeks postpartum. Cardiac output, stroke volume and heart rate increased during pregnancy and total vascular resistance decreased. Long-axis shortening decreased, transmitral A velocity increased (p=0.003) and the ratio of transmitral E to A velocity decreased (p=0.001). DTI early diastolic velocity (E') decreased and late diastolic velocity (A') remained unaltered. DTI systolic velocity (S') and the E/E' ratio did not change significantly during pregnancy. Tei index increased throughout pregnancy (p=0.03). Maternal age was related to E velocity (p=0.001) and E/A ratio (p=0.001) while ethnicity was related to cardiac output (p<0.001), stroke volume (p<0.02) and heart rate (p<0.0001).
  
  
  CONCLUSIONS
  This study gives normal ranges for Doppler tissue imaging measurements, but demonstrates that maternal characteristics may affect these and all measures of systolic and diastolic function.
authors.affiliation: Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, Denmark Hill, Golden Jubilee Wing, London SE5 9RS, UK. jbamfo1@hotmail.com
authors.forename: Jacqueline E A K
authors.initials: JE
authors.lastname: Bamfo
authors.forename: Nikos A
authors.initials: NA
authors.lastname: Kametas
authors.forename: Kypros H
authors.initials: KH
authors.lastname: Nicolaides
authors.forename: John B
authors.initials: JB
authors.lastname: Chambers
mesh_terms: D000328:Adult; D002302:Cardiac Output / Q000502:physiology; D003971:Diastole / Q000502:physiology*; D015150:Echocardiography, Doppler; D005260:Female; D005865:Gestational Age; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008137:Longitudinal Studies; D015233:Models, Statistical; D011247:Pregnancy; D012016:Reference Values; D015203:Reproducibility of Results; D013318:Stroke Volume / Q000502:physiology; D013599:Systole / Q000502:physiology*; D014655:Vascular Resistance / Q000502:physiology