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European Journal of Echocardiography 2007 8(5):360-368; doi:10.1016/j.euje.2006.12.004
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Copyright © 2007, The European Society of Cardiology

Maternal left ventricular diastolic and systolic long-axis function during normal pregnancy

Jacqueline E.A.K. Bamfoa,*, Nikos A. Kametasa, Kypros H. Nicolaidesa and John B. Chambersb

aHarris Birthright Research Centre for Fetal Medicine, King's College Hospital, Denmark Hill, Golden Jubilee Wing, London SE5 9RS, UK
bCardiothoracic Centre, Guy's & St Thomas’ Hospitals, Lambeth Palace Road, London SE1 7EH, UK

Received 9 September 2006; received in revised form 3 December 2006; accepted after revision 15 December 2006.

jbamfo1{at}hotmail.com

* Corresponding author. Tel.: +44 07976 724 728; fax: +44 0207 188 1011.


  Abstract

Aims The aim of this study was to evaluate left ventricular (LV) function during normal pregnancy and investigate the effect of maternal factors. Little information about LV diastolic and long-axis systolic function in normal pregnancy exists.

Methods and results Two hundred and twenty eight Doppler echocardiography and DTI studies of the mitral annulus were performed in 63 normal pregnant women longitudinally at 11–14, 20–24, 26–32, 33–38weeks and 8–12weeks postpartum. Cardiac output, stroke volume and heart rate increased during pregnancy and total vascular resistance decreased. Long-axis shortening decreased, transmitral A velocity increased (p=0.003) and the ratio of transmitral E to A velocity decreased (p=0.001). DTI early diastolic velocity (E') decreased and late diastolic velocity (A') remained unaltered. DTI systolic velocity (S') and the E/E' ratio did not change significantly during pregnancy. Tei index increased throughout pregnancy (p=0.03). Maternal age was related to E velocity (p=0.001) and E/A ratio (p=0.001) while ethnicity was related to cardiac output (p<0.001), stroke volume (p<0.02) and heart rate (p<0.0001).

Conclusion This study gives normal ranges for Doppler tissue imaging measurements, but demonstrates that maternal characteristics may affect these and all measures of systolic and diastolic function.

Keywords: Maternal cardiac function; Doppler Tissue Imaging; Doppler echocardiography


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