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Articles in PresS, published online ahead of print May 23, 2002
Am J Physiol Heart Circ Physiol, 10.1152/ajpheart.00966.2001
Submitted on November 9, 2001
Accepted on May 22, 2002
1 Medicine, University of Sydney, Sydney, NSW, Australia; Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
2 Medicine, University of Sydney, Sydney, NSW, Australia; Renal Medicine, Royal Prince Alfred Hospital, Sydney, NSW, Australia
* To whom correspondence should be addressed. E-mail: richmonj{at}card.rpa.cs.nsw.gov.au.
Increased cardiac output in pregnancy is associated with cardiac remodeling and possible reduction in myocardial contractility, which may be exacerbated by increased afterload in preeclampsia. Left ventricular (LV) geometry and function were compared between non-pregnant controls (n = 12), normotensive (n = 44) and preeclamptic (n = 15) pregnant women, using serial echocardiography. Load-independent comparisons of LV systolic function were made using the relation between end-systolic stress (ESS) and rate-corrected velocity of circumferential fibre shortening (VCFC). Mean arterial pressure was 101 ± 14 mmHg in preeclampsia, 76 ± 6 mmHg in normotensive pregnancy and 78 ± 6 mmHg in controls (p<0.005 vs preeclampsia). LV mass increased during normotensive pregnancy (66 ± 13 g/m2 to 76 ± 16 g/m2, p<0.05; controls 65± 10 g/m2, p<0.05) and was greater in preeclampsia (90 ± 18 g/m2, p<0.05). Change in LV mass during both normotensive and preeclamptic pregnancy was directly related to change in cardiac work. In normotensive pregnancy ESS decreased (59 ± 9 g/cm2 to 52 ± 11 g/cm2, p<0.05; controls 66 ± 14 g/cm2, p<0.005). The ESS was greater in preeclampsia (60 ± 14 g/cm2, p<0.05). In controls, there was an inverse relation between ESS and VCFC (r = -0.78). The ESS - VCFC relations in both normotensive and preeclamptic pregnancy were unchanged from controls. We conclude that LV hypertrophy in both normotensive and preeclamptic pregnancy matches changes in cardiac work and that LV contractility is preserved.
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