Study of the left ventricular function in pregnancy-induced hypertension

• Autores: Escudero, Eduardo Manuel; Favaloro, Liliana Ethel; Moreira, C.; Plastino, Juan Ángel; Pisano, Oscar Eduardo
• Año de publicación: 1988
• Idioma: inglés
• Tipo de recurso: artículo
• Materia: Medicina; pregnancy-induced hypertension; left ventricular function; systolic function; diastolic function; hypertension; pregnancy
• Institución: Universidad Nacional de La Plata

Left ventricular (LV) morphological and functional characteristics in 9 women suffering from pregnancy-induced hypertension (PIH) were studied by means of echocardiograms. In order to distinguish which changes depended on the pressure values and which were the result of pregnancy, 10 nonpregnant control women with no heart disease and 10 normal pregnant women (NP) were studied and the results of each of the groups compared. To evaluate the structure, left ventricular systodiastolic diameters and wall thickness were measured. The only statistically significant difference was in the diastolic diameters between the PIH (4:7±0.3 cm) and the control group (4.4±0.2 cm) p <0.01. Left ventricular mass was significantly increased (p<0.01) in the PIH patients (185±53.1 g) compared to the NP patients (161±29.6 g) and the control group (125±17.4 g). No statistically significant differences were found in the radius thickness ratio in the three groups. The systolic function assessed by the shortening percentage was significantly lower (p <0.05) in the control group (32.8±4.4%) and in the NP patients (37.8±5.2%) than in the PIH group (39±6.5 %). Afterload assessed by isovolumic period stress was significantly greater (p<0.01) in the PIH patients (157±10.6 dyne/cm²) compared with the NP group (118.9±7.01 dyne/cm²). There were no significant differences between the first group and the control group (134.09±8.7 dyne/cm²). As evidence of the diastolic function, analysis was made, on the one hand, of diastolic isovolumic period length (DIP). Values in the control group were 50±8.1 ms, in NP 54±14.2 ms, and in PIH 50±12.2 ms. There were no significant differences between the groups. On the other hand, peak velocity diameter diastolic changes were determined: that of the control group was 18±3.8 cm/s; forthe NP group, 18±5.9 cm/s; and for the PIH group, 21±5.3 cm/s. There were no statistically significant differences here either. The foregoing results lead us to the conclusion that PIH does not produce evident structural changes in the left ventricular cavity beyond those already caused by adaptation to pregnancy. The changes in systolic function may be secondary to the effects of an added adrenergic activity, suggested in turn as being responsible for this hypertension. Diastolic function is not altered despite the increase in the left ventricular mass in this group of patients.
Facultad de Ciencias Médicas