title: Cardiac function at term in human pregnancy.
abstract: OBJECTIVE
  We have previously demonstrated deterioration in cardiac function at term in human pregnancy. To explore further, we investigated central arterial hemodynamics and association with maternal weight during gestation.
  
  
  METHODS
  Primiparous women (n=32) were recruited in a tertiary referral obstetric hospital and a longitudinal cohort study with analyses at median 16 and 37weeks gestation undertaken. Subgroups of normal body mass index, <25kg/m(2), and overweight, ⩾25kg/m(2), at 16weeks were created.
  
  
  METHODS
  We performed 2D speckle tracking echocardiography strain analysis and tonometric measures of central arterial pressures, waveforms and pulse wave velocity.
  
  
  RESULTS
  A reduction in cardiac strain (2P=0.002) from 16 to 37weeks gestation was associated with increased systemic vascular resistance (2P=0.008), reduced arterial compliance (2P=0.004) and increased central arterial pressures (2P<0.001) and augmentation index (2P=0.001).
  
  
  CONCLUSIONS
  By 37weeks, compared with values in earlier pregnancy, overweight women had higher systemic vascular resistance (2P<0.05). Additionally, their central diastolic pressure was higher (2P<0.05) and their ventricular strain was lower (2P<0.05) than in normal weight pregnant women. An increase in systemic vascular resistance and central arterial pressures by term may contribute to the observed deterioration in cardiac function. This appears more prominent in overweight women.
authors.affiliation: Department of Cardiology, The Royal Melbourne Hospital, Parkville, Vic. 3050, Australia; Department of Physiology, The University of Melbourne, Parkville, Vic. 3010, Australia. Electronic address: dominica.zentner@mh.org.au.
authors.forename: Dominica
authors.initials: D
authors.lastname: Zentner
authors.affiliation: Department of Cardiology, The Royal Melbourne Hospital, Parkville, Vic. 3050, Australia.
authors.forename: Moira
authors.initials: M
authors.lastname: du Plessis
authors.affiliation: Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, Vic. 3010, Australia; Department of Perinatal Medicine, The Royal Women's Hospital, Carlton, Vic. 3053 Australia.
authors.forename: Shaun
authors.initials: S
authors.lastname: Brennecke
authors.affiliation: Department of Cardiology, The Royal Melbourne Hospital, Parkville, Vic. 3050, Australia.
authors.forename: James
authors.initials: J
authors.lastname: Wong
authors.affiliation: Department of Cardiology, The Royal Melbourne Hospital, Parkville, Vic. 3050, Australia.
authors.forename: Leeanne
authors.initials: L
authors.lastname: Grigg
authors.affiliation: Department of Physiology, The University of Melbourne, Parkville, Vic. 3010, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Harrap
keywords: Body weight; Cardiovascular physiology; Echocardiography; Hemodynamics; Pregnancy; Transthoracic