ABSTRACT
Chronic hypertension induces changes in the structure of the left ventricle, atrium, and aortic root. However, the effects of transient hypertension are unclear. Pregnancy-induced hypertension (PIH) offers a natural and spontaneous model of this condition. Using M-mode echocardiography, we studied 95 consecutive patients with PIH, who were compared with 83 normal pregnant women (NPW). We evaluated diastolic diameter (DD), systolic diameter (SD), septal thickness (ST), posterior wall thickness (PWT), shortening fraction (SF), relative wall thickness (RWT), left ventricular mass index (LVMI), left atrial dimension (LAD), and aortic root dimension (ARD). Patients with PIH had higher ST (9.98 +/- 1.47 mm v 8.96 +/- 1.43 mm, P < .000), PWT (9.28 +/- 1.48 mm v 8.55 +/- 1.35 mm, P < .000), LVMI (107.65 +/- 27.87 g/m2 v 92.38 +/- 17.99 g/m2, P < .000), and RWT (0.406 +/- 0.06 v 0.377 +/- 0.06 mm, P < .002). There were no significant differences in DD, SD, SF, LAD, and ARD. In conclusion, PIH increases the LVMI due to an increase in the ST and PWT. The dimensions of the left ventricle, left atrium, and aortic root do not change.
Subject(s)
Aorta/diagnostic imaging , Echocardiography , Hypertension/diagnostic imaging , Pregnancy Complications, Cardiovascular/diagnostic imaging , Adolescent , Adult , Female , Heart Atria , Heart Septum/diagnostic imaging , Heart Ventricles , Humans , PregnancyABSTRACT
The changes induced by transient hypertension upon cardiac geometry (G) are unclear. Pregnancy-induced hypertension (PIH) offers a natural and spontaneous model of this condition. To assess geometric changes according to two-dimensionally guided M-mode echocardiography, we compared patients with PIH with normal pregnant women (NPW). Fifty-five women, aged 28.5 +/- 7.5 years, with PIH (defined as blood pressure >140/90 mm Hg in the third trimester of pregnancy and without a history of hypertension) were compared with 57 NPW aged 30.7 +/- 7.5 years. Left ventricular mass index (LVMI) (Devereux formula) and relative wall thickness (RWT) (Ganau formula) were calculated by means of echocardiography done in the left lateral decubitus 2 to 4 days postpartum. Subjects were considered to have: normal geometry (NG) if both LVMI and RWT fell below the mean +/- 1 SD or 2 SD; concentric hypertrophy (CH) if both were elevated; eccentric hypertrophy (EH) if LVMI was elevated and RWT was normal; and concentric remodeling (CR) if LVMI was normal and RWT was elevated. Comparisons were performed by the Student t test. Patients with PIH had higher LVMI (106 +/- 29.4 v 90.6 +/- 19.8 g/m2; P < .05) and RWT (0.41 +/- 0.07 v 0.38 +/- 0.05; P < .05). Considering the mean +/- 1 SD of NPW as the limit of normality the G pattern was NG in 26 (47%) and abnormal in 29 (53%), of which 14 (25.5%) had EH, 11 (20%) had CR, and four (7%) had CH. If we considered the mean +/- 2 SD, the G pattern was NG in 46 (84%) and abnormal G in nine (16%), EH in four (7%), CR in three (5%), and CH in 2 (4%). According to these data, women with PIH had higher LVMI and RWT compared with NPW. The most frequent abnormal G patterns were EH and CR.