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Alteration of Pregnant Women Heart Mechanics Assessed by Speckle Tracking Echocardiography During Pregnancy

Yıl 2017, Cilt: 20 Sayı: 3, 235 - 239, 03.12.2017

Öz

Introduction:
The
purpose of this study was to evaluate left ventricular myocardial mechanics
using 2-dimensional speckle tracking echocardiography (2D-STE) during normal,
uncomplicated pregancy and postpartum term.



Patients
and Methods:
In this prospective, longitudinal study, 86 healthy
pregnant women who underwent serial 2 dimensional echocardiographic evaluation
during each trimester (trimester one 8-12 weeks; trimester two 20-24 weeks,
trimester three 32-36 weeks, and postpartum 10-14 weeks). Two-dimensional STE
was performed to measure global left ventricular longitudinal, circumferential,
and radial strain (GLS, GCS, and GRS, respectively).



Results: GLS showed
a decrease during pregnancy (for first trimester 21.0 ± 2.1%; for second
trimester 19.9 ± 1.8%; for third trimester 18.2 ± 2.1; for postpartum 19.1 ±
1.4, p< 0.001). GCS was significantly reduced during pregnancy (p= 0.033)
and peaked as the same value in the first trimester. GRS remained unchanged
throughout the pregnancy and labor (p= 0.033).



Conclusion: This study gives normal
ranges of 2D indices in pregnancy. 2D STE demonstrated that LV longitudinal and
circumferantial strain are significantly reduced, whereas radial strain
remained unchanged.

Kaynakça

  • 1. Siu SC, Sermer M, Colman JM, Alvarez AN, Mercier LA, Morton BC, et al. Prospective multicenter study of pregnancy outcomes in women with heart disease. Circulation 2001;104:515-21.
  • 2. Mabie WC, DiSessa TG, Crocker LG, Sibai BM, Arheart KL. A longitudinal study of cardiac output in normal human pregnancy. Am J Obstet Gynecol 1994;170:849-56.
  • 3. Cong J, Fan T, Yang X, Squires JW, Cheng G, Zhang L, et al. Cardiovasc Ultrasound 2015;13:6.
  • 4. Robson SC, Hunter S, Boys RJ, Dunlop W. Serial study of factors influencing changes in cardiac output during human pregnancy. Am J Physiol 1989;256:H1060-5.
  • 5. Gilson GJ, Samaan S, Crawford MH, Qualls CR, Curet LB. Changes in hemodynamics, ventricular remodeling, and ventricular contractility during normal pregnancy: a longitudinal study. Obstet Gynecol 1997;89:957-62.
  • 6. Gilson GJ, Mosher MD, Conrad KP. Systemic hemodynamics and oxygen transport during pregnancy in chronically instrumented, conscious rats. Am J Physiol 1992;263:H1911-8.
  • 7. Valensise H, Novelli GP, Vasapollo B, Borzi M, Arduini D, Galante A, et al. Maternal cardiac systolic and diastolic function: relationship with uteroplacental resistances. A Doppler and echocardiographic longitudinal study. Ultrasound Obstet Gynecol 2000;15:487-97.
  • 8. Geyer H, Caracciolo G, Abe H, Wilansky S, Carerj S, Gentile F, et al. Assessment of myocardial mechanics using speckle tracking echocardiography: fundamentals and clinical applications. J Am Soc Echocardiogr 2010;23:351-69.
  • 9. Gottdiener JS, Bednarz J, Devereux R, Gardin J, Klein A, Manning WJ, et al. American Society of Echocardiography recommendations for use of echocardiography in clinical trials. J Am Soc Echocardiogr 2004;17:1086-119.
  • 10. Quinones MA, Otto CM, Stoddard M, Waggoner A, Zoghbi WA; Doppler Quantification Task Force of the Nomenclature and Standards Committee of the American Society of Echocardiography. Recommendations for quantification of Doppler echocardiography: a report from the Doppler Quantification Task Force of the Nomenclature and Standards Committee of the American Society of Echocardiography. J Am Soc Echocardiogr 2002;15:167-84.
  • 11. Savu O, Jurcut R, Giusca S, van Mieghem T, Gussi I, Popescu BA, et al. Morphological and functional adaptation of the maternal heart during pregnancy. Circ Cardiovasc Imaging 2012;5:289-97.
  • 12. Ando T, Kaur R, Holmes AA, Brusati A, Fujikura K, Taub CC. Physiological adaptation of the left ventricle during the second and third trimesters of a healthy pregnancy: a speckle tracking echocardiography study. Am J Cardiovasc Dis 2015;5:119-26.
  • 13. Sengupta SP, Bansal M, Hofstra L, Sengupta PP, Narula J. Gestational changes in left ventricular myocardial contractile function: new insights from two-dimensional speckle tracking echocardiography. Int J Cardiovasc Imaging 2017;33:69-82.
  • 14. Sengupta PP, Narula J. Reclassifying heart failure: predominantly subendocardial, subepicardial, and transmural. Heart Fail Clinyöhkujj 2008;4:379-82.

Gebelikte Speckle Tracking Ekokardiyografisi ile Değerlendirilen Anne Kalbinin Mekanik Fonksiyonlarının Değişimi

Yıl 2017, Cilt: 20 Sayı: 3, 235 - 239, 03.12.2017

Öz

Giriş: Bu çalışmanın amacı sağlıklı gebelerde, gebelik süresince ve sonrasında sol
ventrikül fonksiyonlarındaki değişimi “iki boyutlu speckle tracking
ekokardiyografi (STE)” yöntemi ile araştırmaktır.



Hastalar ve
Yöntem:
Çalışmaya 86 sağlıklı gebe dahil edilmiş ve gebeliğin
birinci trimester 8-12 hafta, ikinci trimester 20-24 hafta, üçüncü trimester
32-36 hafta ve postpartum 10-14. haftada 2 boyutlu ekokardiyografi ile
kayıtları alınmıştır. Sol ventrikül global longitüdinal strain (SV-GLS), sol
ventrikül global radiyal strain (SV-GRS), sol ventrikül global sirkumferansiyel
strain (SV-GCS) değerleri not edilmiştir.



Bulgular: SV-GLS birinci trimester için -%21.0 ± 2.1; ikinci. trimester için -%19.9 ±
1.8; üçüncü trimester için -%18.2 ± 2.1; postpartum -%19.1 ± 1.4, p< 0.001).
SV-GCS gebelik boyunca anlamlı olarak azalırken (p= 0.033), post partum dönemde
1.ci trimesterde bulunan değerlerine yükseldi. SV-GRS değerlerinde gebelik
boyunca değişiklikler istatistiksel olarak anlamlı bulunmadı (p= 0.103).



Sonuç: Bu çalışmada STE ile
değerlendirilen, SV-GLS ve SV-GCS ile mekanik fonksiyonlarının anlamlı bir
şekilde değiştiğini ve SV-GRS’de bir değişim olmadığını saptadık.

Kaynakça

  • 1. Siu SC, Sermer M, Colman JM, Alvarez AN, Mercier LA, Morton BC, et al. Prospective multicenter study of pregnancy outcomes in women with heart disease. Circulation 2001;104:515-21.
  • 2. Mabie WC, DiSessa TG, Crocker LG, Sibai BM, Arheart KL. A longitudinal study of cardiac output in normal human pregnancy. Am J Obstet Gynecol 1994;170:849-56.
  • 3. Cong J, Fan T, Yang X, Squires JW, Cheng G, Zhang L, et al. Cardiovasc Ultrasound 2015;13:6.
  • 4. Robson SC, Hunter S, Boys RJ, Dunlop W. Serial study of factors influencing changes in cardiac output during human pregnancy. Am J Physiol 1989;256:H1060-5.
  • 5. Gilson GJ, Samaan S, Crawford MH, Qualls CR, Curet LB. Changes in hemodynamics, ventricular remodeling, and ventricular contractility during normal pregnancy: a longitudinal study. Obstet Gynecol 1997;89:957-62.
  • 6. Gilson GJ, Mosher MD, Conrad KP. Systemic hemodynamics and oxygen transport during pregnancy in chronically instrumented, conscious rats. Am J Physiol 1992;263:H1911-8.
  • 7. Valensise H, Novelli GP, Vasapollo B, Borzi M, Arduini D, Galante A, et al. Maternal cardiac systolic and diastolic function: relationship with uteroplacental resistances. A Doppler and echocardiographic longitudinal study. Ultrasound Obstet Gynecol 2000;15:487-97.
  • 8. Geyer H, Caracciolo G, Abe H, Wilansky S, Carerj S, Gentile F, et al. Assessment of myocardial mechanics using speckle tracking echocardiography: fundamentals and clinical applications. J Am Soc Echocardiogr 2010;23:351-69.
  • 9. Gottdiener JS, Bednarz J, Devereux R, Gardin J, Klein A, Manning WJ, et al. American Society of Echocardiography recommendations for use of echocardiography in clinical trials. J Am Soc Echocardiogr 2004;17:1086-119.
  • 10. Quinones MA, Otto CM, Stoddard M, Waggoner A, Zoghbi WA; Doppler Quantification Task Force of the Nomenclature and Standards Committee of the American Society of Echocardiography. Recommendations for quantification of Doppler echocardiography: a report from the Doppler Quantification Task Force of the Nomenclature and Standards Committee of the American Society of Echocardiography. J Am Soc Echocardiogr 2002;15:167-84.
  • 11. Savu O, Jurcut R, Giusca S, van Mieghem T, Gussi I, Popescu BA, et al. Morphological and functional adaptation of the maternal heart during pregnancy. Circ Cardiovasc Imaging 2012;5:289-97.
  • 12. Ando T, Kaur R, Holmes AA, Brusati A, Fujikura K, Taub CC. Physiological adaptation of the left ventricle during the second and third trimesters of a healthy pregnancy: a speckle tracking echocardiography study. Am J Cardiovasc Dis 2015;5:119-26.
  • 13. Sengupta SP, Bansal M, Hofstra L, Sengupta PP, Narula J. Gestational changes in left ventricular myocardial contractile function: new insights from two-dimensional speckle tracking echocardiography. Int J Cardiovasc Imaging 2017;33:69-82.
  • 14. Sengupta PP, Narula J. Reclassifying heart failure: predominantly subendocardial, subepicardial, and transmural. Heart Fail Clinyöhkujj 2008;4:379-82.
Toplam 14 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Tıp Bilimleri
Bölüm Orijinal Araştırmalar
Yazarlar

Ali Karagöz Bu kişi benim

Onur Taşar Bu kişi benim

Şeyhmus Külahçıoğlu Bu kişi benim

Bünyamin Şan Bu kişi benim

Arzu Kalaycı Bu kişi benim

Tahir Bezgin Bu kişi benim

Gönenç Kocabay Bu kişi benim

İbrahim Akın İzgi Bu kişi benim

Cevat Kırma Bu kişi benim

Yayımlanma Tarihi 3 Aralık 2017
Yayımlandığı Sayı Yıl 2017 Cilt: 20 Sayı: 3

Kaynak Göster

Vancouver Karagöz A, Taşar O, Külahçıoğlu Ş, Şan B, Kalaycı A, Bezgin T, Kocabay G, İzgi İA, Kırma C. Gebelikte Speckle Tracking Ekokardiyografisi ile Değerlendirilen Anne Kalbinin Mekanik Fonksiyonlarının Değişimi. Koşuyolu Heart Journal. 2017;20(3):235-9.