Haemodynamics in women with untreated pre-eclampsia.
This study aimed to compare the haemodynamics in healthy pregnant women with the haemodynamics in women with untreated pre-eclampsia, to determine the cardiovascular reason for hypertension in pre-eclampsia. 40 women with untreated pre-eclampsia, 40 matched healthy pregnant women and 20 non-pregnant women were studied using transthoracic echocardiography. Untreated pre-eclampsia demonstrated (mean (SD), healthy non-pregnant vs healthy pregnant vs untreated pre-eclampsia) increased cardiac output (3400 (752) vs 4109 (595) vs 4789 (1416) ml.min(-1), p=0.002), increased stroke volume (53 (10) vs 53 (8) vs 59 (13) ml, p=0.04), increased fractional shortening (35 (5) vs 35 (7) vs 41 (8) %, p=0.006), increased fractional area change (57 (7) vs 57 (9) vs 65 (9)%, p=0.002) and increased systemic vascular resistance (2116 (457) vs 1613 (315) vs 2016 (625) dyne.s.cm(-5), p=0.001). Mitral E/septal e' was higher (6.0 (1.1) vs 6.7 (1.3) vs 10.4 (2.4), p=0.002) and left atrial size increased (3.2 (0.3) vs 3.8 (0.4) vs 4.0 (0.4) cm, p=0.002). Hypertension in untreated pre-eclampsia is due to increased cardiac output and mild vasoconstriction, with increased inotropy and reduced diastolic function.
Department of Anaesthesia, The Royal Women's Hospital Parkville and Department of Pharmacology, The University of Melbourne, Victoria, Australia. adennis@unimelb.edu.au
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Dennis
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Castro
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Carr
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Simmons
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Permezel
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Royse
D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D002302:Cardiac Output / Q000502:physiology; D003971:Diastole; D004452:Echocardiography; D005260:Female; D006334:Heart Function Tests; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D015588:Observer Variation; D010298:Parity; D011225:Pre-Eclampsia / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011247:Pregnancy; D013318:Stroke Volume / Q000502:physiology; D013599:Systole; D014655:Vascular Resistance / Q000502:physiology; D014661:Vasoconstriction / Q000502:physiology