Abstract 16377: Normal Cardiac Adaptation During Pregnancy - Assessment by Velocity Vector Imaging and Three-Dimensional Echocardiography in Healthy Pregnant Women
Background: The heart undergoes morphological and physiological changes during pregnancy. Three-dimensional (3D) echocardiography (echo) allows chamber volume assessment independent of geometric assumption & velocity vector imaging (VVI) allows assessment of myocardial function by 2D strain. We examined serial changes in chamber volumes by 3D echo and in strain rate of the right and left ventricle (RV & LV) and of left atrium in healthy pregnant women.
Methods: Serial 2D and 3D echoes were performed in 45 healthy pregnant women in each trimester and post-partum. 3D volumes were measured off line on Tom Tec and 2D radial and longitudinal strain on Syngo VVI.
Results: There was an increase in 3D LV and RV end systolic and end diastolic volumes during pregnancy that reversed after delivery. No change in RV ejection fraction (EF) was seen & a slight decrease in LVEF in the 3rd trimester vs post partum (Table). There was an increase in LV radial strain rate in the 1st & 2nd trimester, in LV longitudinal strain rate in the 2nd & 3rd trimester and in RV longitudinal strain rate in the 1st & 2nd trimester vs post partum (Figure). Left atrial strain rate A wave increased in the 1st & 2nd trimester along with an increase in atrial contraction velocity in the 3rd trimester on PW Doppler of mitral inflow (65±14 vs 57±14 cm/s, p<0.05) vs postpartum.
Conclusions: Cardiac adaptation during normal pregnancy comprises of significant increase in LV radial strain rate and in LV and RV longitudinal strain rate. These changes along with an increase in left atrial strain rate and function allow accommodation of an increasing chamber volume and stroke volume during pregnancy.
- © 2013 by American Heart Association, Inc.