Left ventricular function in gestational hypertension: serial echocardiographic study.
BACKGROUND
Gestational hypertension (GH) is associated with hemodynamic changes, and alterations of systolic and diastolic left ventricular (LV) function. However, the magnitude and pattern of changes of different parameters of LV function and contractility in this patient population have not been fully clarified.


METHODS
Thirty-five pregnant women with GH underwent three echocardiographic examinations, in second and third trimester of pregnancy, and 1 month after delivery. Twelve normotensive pregnant women served as gestational age-matched controls. Hemodynamic parameters and standard indexes of LV systolic and diastolic function were analyzed. Additionally, we have measured peak systolic velocity of mitral annulus (S'), end-systolic elastance (Ees), and early transmitral to early lengthening velocity of mitral annulus ratio (E/E') as parameters of longitudinal function, contractility, and filling, respectively.


RESULTS
Women with GH had initially higher body weight, blood pressure, and heart rate (P < 0.005, P < 0.0001, and P = 0.011, respectively). Temporal analysis of different echocardiographic parameters revealed increase in wall thickness from baseline to second measurement, with consequential increase in LV mass in women with GH (P = 0.014 for septum, P = 0.010 for posterior wall, and P = 0.09 for LV mass). No significant changes of LV volumes, ejection fraction (EF), transmitral flow parameters, S', Ees, and E/E' were observed throughout the follow-up in both groups (P = nonsignificant for all). Importantly, pattern of changes was similar in both groups for all examined parameters (P = nonsignificant between groups, for all).


CONCLUSIONS
It appears that changes of LV longitudinal function, filling, and contractility during pregnancy are not significant and not influenced by GH.
Vlahović-Stipac
Alja
A
Department of Cardiology, Clinical Hospital Center Zemun, Belgrade, Serbia. avlahovic@hotmail.com
Stankić
Vera
V
Popović
Zoran B
ZB
Putniković
Biljana
B
Nesković
Aleksandar N
AN
D000328:Adult; D001794:Blood Pressure; D001835:Body Weight; D003326:Coronary Circulation; D003971:Diastole; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate; D006346:Heart Septum / Q000000981:diagnostic imaging; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D009200:Myocardial Contraction; D049590:Postpartum Period; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D013599:Systole; D013997:Time Factors; D016277:Ventricular Function, Left; D055815:Young Adult