Left ventricular mechanics in late second trimester of healthy pregnancy
Meah, Victoria L.
Cockcroft, John R.
Stöhr, Eric J.
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Objective: To evaluate left ventricular (LV) mechanics in the second trimester of healthy pregnancy and to determine the influence of underpinning hemodynamics (heart rate (HR), preload and afterload) on LV mechanics during gestation. Methods: This was a cross‐sectional study of 18 non‐pregnant, 14 nulliparous pregnant (22–26 weeks' gestation) and 13 primiparous postpartum (12–16 weeks after delivery) women. All pregnant and postpartum women had uncomplicated, singleton gestations. Cardiac structure and function were assessed using echocardiography. LV mechanics, specifically longitudinal strain, circumferential strain and twist/untwist, were measured using speckle‐tracking echocardiography. Differences between groups were identified using ANCOVA, with age, HR, end‐diastolic volume (EDV) and systolic blood pressure (SBP) as covariates. Relationships between LV mechanics and hemodynamics were examined using Pearson's correlation. Results: There were no significant differences in LV structure and traditional measurements of systolic and diastolic function between the three groups. Pregnant women, compared with non‐pregnant ones, had significantly higher resting longitudinal strain (–22 ± 2% vs –17 ± 3%; P = 0.002) and basal circumferential strain (–23 ± 4% vs –16 ± 2%; P = 0.001). Apical circumferential strain and LV twist and untwist mechanics were similar between the three groups. No statistically significant relationships were observed between LV mechanics and HR, EDV or SBP within the groups. Conclusions: Compared to the non‐pregnant state, pregnant women in the second trimester of a healthy pregnancy have significantly greater resting systolic function, as assessed by LV longitudinal and circumferential strain. Contrary to previous work, these data show that healthy pregnant women should not exhibit reductions in resting systolic function between 22 and 26 weeks' gestation. The enhanced myocardial contractile function during gestation does not appear to be related to hemodynamic load and could be the result of other physiological adaptations to pregnancy.
Ultrasound in Obstetrics and Gynecology;
Meah, V.L., Backx, K., Cockcroft, J.R., Shave, R. and Stöhr, E.J. (2018) 'Left ventricular mechanics in the late second trimester of healthy pregnancy', Ultrasound in Obstetrics & Gynecology, 54(3), pp.350-358. DOI: 10.1002/uog.20177.
Dynodwr Gwrthrych Digidol (DOI)https://doi.org/10.1002/uog.20177
Article published in Ultrasound in Obstetrics & Gynecology on 04 September 2019, available at: https://doi.org/10.1002/uog.20177.
Cardiff Metropolitan University (Grant ID: Cardiff Metropolian (Internal))
- Sport Research Groups 
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Meah, Victoria L.; Backx, Karianne; Cockcroft, John R.; Shave, Rob; Stöhr, Eric J. (American College of Sports Medicine, 2021-05-01)Purpose The increased physiological demand of pregnancy results in the profound adaptation of the maternal cardiovascular system, reflected by greater resting cardiac output and left ventricular (LV) deformation. Whether ...
Comparison between Modelflow® and echocardiography in the determination of cardiac output during and following pregnancy at rest and during exercise Meah, Victoria L.; Backx, Karianne; Shave, Rob; Stöhr, Eric J.; Cooper, Stephen-Mark (Facultad de Educación, 2020-07-23)During pregnancy, assessment of cardiac output (Q ̇), a fundamental measure of cardiovascular function, provides important insight into maternal adaptation. However, methods for dynamic Q ̇ measurement require validation. ...
The maternal cardiovascular system at rest and in response to functional haemodynamic testing during healthy pregnancy Meah, Victoria L. (Cardiff Metropolitan University, 2017)Healthy pregnancy results in significant maternal cardiac adaptation to match the increased circulatory demands of the developing fetoplacental unit. Specifically, cardiac output, heart rate (HR), stroke volume (SV) and ...