Pulmonary artery dilatation during normal pregnancy.

BACKGROUND: During pregnancy the cardiovascular system undergoes complex alterations; however, there have been few studies concerning pulmonary artery behaviour during gestation. AIM: The aim of this study was to evaluate changes in the pulmonary artery diameter (PAD) during gestation, with respect to left ventricular (LV) load and remodelling, as well as to systemic vascular resistance (SVR). METHODS: It was a prospective cohort study, which included 69 consecutive healthy outpatient women with a singleton pregnancy. Echocardiography and ultrasonography of the uterine arteries were performed at two visits (V1 and V2) during pregnancy, and only echocardiography at one visit postpartum. RESULTS: Pulmonary artery diameter increased in all women, from 20.0 mm at V1 to 22.7 mm at V2 (p < 0.001), and it returned to the reference range postpartum (19.5 mm; p < 0.001 vs. V2). Echocardiography did not reveal any other abnormalities, including the signs of intracardiac shunt or right ventricular pressure overload. During V2, PAD positively correlated with the following echocardiographic parameters: LV end-diastolic diameter (r = 0.386; p = 0.002), LV end-systolic diameter (r = 0.345 p = 0.006), LV end-diastolic volume (r = 0.308; p = 0.016), LV mass (r = 0.459; p < 0.001), left atrial area (r = 0.334; p = 0.009), LV cardiac output (r = 0.338; p = 0.011), and aortic diameter (r = 0.369; p = 0.003). Furthermore, there was a negative linear correlation between PAD and SVR (r = -0.307; p = 0.025) and pulsatility index (r = -0.318; p = 0.012). CONCLUSIONS: Our study shows pulmonary artery dilatation in healthy pregnant women without any other abnormal echocardiographic findings. These changes in PAD are associated with volume overload and low vascular resistance, and during postpartum they usually subside.

Relationship between abdominal obesity, platelet blood count and mean platelet volume in patients with metabolic syndrome.

AIM: There is evidence that patients with the metabolic syndrome have altered platelet indices including higher mean platelet volume. According to the 2009 International Diabetes Federation criteria of metabolic syndrome diagnosis, elevated waist circumference (≥94 cm in M, ≥80 cm in F), as a determinant of abdominal obesity, is not an obligatory component. The aim of this study was to evaluate the relationship between platelet indices, including mean platelet volume, and abdominal obesity in patients with metabolic syndrome. METHODS: 382 consecutive patients were enrolled in the study and divided into three groups: group A, 218 patients with metabolic syndrome and abdominal obesity (132 M, mean age 65.3 ± 10.9 yrs); group B, 35 patients with metabolic syndrome without abdominal obesity (28 M, mean age 63.3 ± 11.2 yrs); and, group C, 129 patients without metabolic syndrome and without abdominal obesity (99 M, mean age 62.2 ± 13.8 yrs). RESULTS: In group A, mean platelet volume was significantly higher than in group C (10.70 ± 1.01 vs. 10.35 ± 0.94 fL, p = 0.007). However, there was no difference in mean platelet volume between group A and B (10.70 ± 1,01vs. 10.63 ± 1.03 fL, p >0.05). Furthermore, in group A, mean platelet volume was correlated with waist circumference (r = 0.14, p = 0.041) and body mass index (r = 0.14, p = 0.045). In all study groups, a significant association between mean platelet volume and platelet count (r = -0.33, p <0.001) was found. CONCLUSION: In individuals with metabolic syndrome and abdominal obesity mean platelet volume is positively correlated with waist circumference and significantly higher than in patients without these abnormalities.