Structural and functional changes in left ventricle during normotensive and preeclamptic pregnancy

Lisa A. Simmons, Adrian G. Gillin, Richmond W. Jeremy

Abstract

Increased cardiac output in pregnancy is associated with cardiac remodeling and possible reduction in contractility, which may worsen in preeclampsia. Left ventricular (LV) geometry and function were compared between nonpregnant controls (n = 12) and normotensive (n = 44) and preeclamptic (n = 15) pregnant women using echocardiography. Load-independent comparisons of LV systolic function compared end-systolic stress (ESS) and rate-corrected velocity of circumferential fiber shortening (V CFC). Mean arterial pressures were 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 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). In normotensive pregnancy, ESS decreased (59 ± 9 to 52 ± 11 g/cm2; P < 0.05; controls, 66 ± 14 g/cm2; P < 0.005). ESS was greater in preeclampsia (60 ± 14 g/cm2;P < 0.05). In controls, there was an inverse relationship between ESS and V CFC(r = −0.78). The ESS-V CFCrelationships in normotensive and preeclamptic pregnancy were unchanged from controls. We conclude that LV hypertrophy in normotensive and preeclamptic pregnancy matches changes in cardiac work, and LV contractility is preserved.

  • preeclampsia
  • echocardiography
  • ventricular function
  • myocardial contractility
  • hypertension

Footnotes

  • Address for reprint requests and other correspondence: R. W. Jeremy, Dept. of Cardiology, Royal Prince Alfred Hospital, Missenden Rd., Camperdown, Sydney, New South Wales 2050, Australia (E-mail:richmonj{at}card.rpa.cs.nsw.gov.au).

  • The costs of publication of this article were defrayed in part by the payment of page charges. The article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

  • May 23, 2002;10.1152/ajpheart.00966.2001

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