J Cardiovasc Ultrasound.
2016 Mar;24(1):28-34. 10.4250/jcu.2016.24.1.28.
Echocardiographic Assessment of Structural and Hemodynamic Changes in Hypertension-Related Pregnancy
- Affiliations
-
- 1Division of Cardiology, Department of Internal Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
- 2Division of Cardiology, Department of Internal Medicine, Hallym Hospital, Incheon, Korea.
- 3Division of Cardiology, Department of Internal Medicine, Kosin University School of Medicine, Busan, Korea.
- 4Division of Cardiology, Department of Internal Medicine, NHIC Ilsan Hospital, Goyang, Korea.
- 5Division of Cardiology, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
- 6Division of Cardiology, Department of Internal Medicine, Gachon University, Gil Medical Center, Incheon, Korea. msshin@gilhospital.com
- KMID: 2160992
- DOI: http://doi.org/10.4250/jcu.2016.24.1.28
Abstract
- BACKGROUND
Pregnancy induces dramatic cardiovascular changes in order to meet the increasing metabolic needs. Adaptive change of left ventricle (LV) might be modified in pregnancy complicated by hypertension.
METHODS
Data from 193 consecutive pregnant women were analyzed. Clinical and echocardiographic data were compared in normotensive and hypertensive women.
RESULTS
Significantly higher LV mass indexed by height was observed in hypertensive women compared with normotensive women (84 ± 21 g/m vs. 97 ± 20 g/m, p = 0.001). Diastolic function measured by the ratio of peak velocity of early diastolic transmitral blood flow to early diastolic mitral annular velocity was impaired in hypertensive women (11.0 ± 3.0 vs. 9.2 ± 2.5, p < 0.001). Such change was more prominent in women with gestational hypertension (GH) than those with chronic hypertension (CH). Heavy maternal weight was an independent factor associated with LV hypertrophy (LVH) in both normotensive and hypertensive women. Overt eccentric LVH was more frequent than concentric remodeling/hypertrophy (24% vs. 8.4%) in GH, while the opposite result was observed in CH (14% vs. 23%).
CONCLUSION
Hypertensive pregnancy is associated with significant LVH and diastolic dysfunction. CH seems to induce different LV remodeling pattern from GH. Heavy maternal weight during pregnancy might intensify the unfavorable remodeling of LV, particularly in hypertensive pregnancy.
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