title: Effect of physiological overload on pregnancy in women with mitral regurgitation.
abstract: OBJECTIVE
  to evaluate the structural and functional heart abnormalities in women with mitral regurgitation during pregnancy.
  
  
  BACKGROUND
  Women with mitral regurgitation progress well during pregnancy. However, the effects on the heart of the association between pregnancy and mitral regurgitation are not well established.
  
  
  METHODS
  This is a case-control, longitudinal prospective study. Echocardiograms were performed in 18 women with mitral regurgitation at the 12th and 36th week of pregnancy and on the 45th day of the puerperium. Twelve age-matched healthy and pregnant women were included as controls and underwent the same evaluation as the study group.
  
  
  RESULTS
  Compared with controls, women with mitral regurgitation presented increased left cardiac chambers in all evaluations. Increasing left atrium during pregnancy occurred only in the mitral regurgitation group. At the end of the puerperium, women with mitral regurgitation showed persistent enlargement of the left atrium compared with the beginning of pregnancy (5.0 ± 1.1 cm vs 4.6 ± 0.9 cm; p < 0.05). Reduced left ventricular relative wall thickness (0.13 ± 0.02 vs 0.16 ± 0.02; p < 0.05) and an increased peak of afterload (278 ± 55 g/cm² vs 207 ± 28 g/cm²; p < 0.05) was still observed on the 45th day after delivery in the mitral regurgitation group compared with controls.
  
  
  CONCLUSIONS
  Pregnancy causes unfavorable structural alterations in women with mitral regurgitation that are associated with an aggravation of the hemodynamic overload.
authors: Department of Obstetrics and Gynaecology, Botucatu Medical School, São Paulo State University, Botucatu, São Paulo, Brazil. vborges@fmb.unesp.br
authors: Vera T M
authors: VT
authors: Borges
authors: Beatriz B
authors: BB
authors: Matsubara
authors: Claudia G
authors: CG
authors: Magalhães
authors: Jose C
authors: JC
authors: Peraçoli
authors: Marilza V C
authors: MV
authors: Rudge
mesh_terms: D000704:Analysis of Variance; D002306:Cardiac Volume; D006332:Cardiomegaly / Q000209:etiology; D016022:Case-Control Studies; D005260:Female; D005865:Gestational Age; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011446:Prospective Studies; D013997:Time Factors; D014463:Ultrasonography; D016277:Ventricular Function, Left / Q000502:physiology