Left Atrial Function during Pregnancy: A Three-Dimensional Echocardiographic Study.

Summary of "Left Atrial Function during Pregnancy: A Three-Dimensional Echocardiographic Study."

Background: Alteration of diastolic function is considered a sensitive means for detecting changes in the normal cardiac adaptation to pregnancy. Our aim was to evaluate volumetric and functional atrial parameters, using real time three-dimensional echocardiography (RT3DE) in women in early and late third trimester of pregnancy. Methods: We studied pregnant women in early third trimester (III-E = gestational age 26-33 weeks), in late third trimester (III-L = gestational age 34-40 weeks), and control nonpregnant women (C). Two-dimensional (2D-Echo) and RT3DE were used to study 3D left atrial (LA) systolic and diastolic stroke volumes and index (LASVI, LAEDVI), emptying fraction, left ventricular and LA cavities. Results: Although the LA end systolic volume index increased significantly (from 19.42 ± 0.1 to 24.7 ± 3.5 mm(2) , P < 0.01), the EF did not change significantly. This was mainly achieved by increasing atrial contraction (A-wave), maintaining cardiac output by increasing heart rate. A decrease in diastolic E-wave, increased atrial kick (A-wave) with reduced E/A ratio, was noted as the pregnancy progressed. Pulmonary pressure increased from 16.9 ± 6.6 to 20.5 ± 2.9 mmHg (P < 0.01), Using 2D-Echo revealed no change in LA diameter from control to III-E and III-L, respectively (from 17.1 ± 2.3 to 16.7 ± 2.6, 17.5 ± 2.2 mm) and area (from 11.7 ± 3.1 to 16.5 ± 2.3, 17.6 ± 1.6 cm(2) ). However, using RT3DE, a significant increase in the LASVI, LAEDVI, and LA stroke volume index (from 12.02 ± 2.5 to 14.7 ± 3.2, and 15.1 ± 2.7 mL/m(2) ) was detected. Conclusions: Enlargement of the LA volume with unchanged blood pressure values, as found using RT3DE, may be part of the adaptation to increased blood volume during pregnancy. (Echocardiography, 2012;**:1-6).

Affiliation

Department of Cardiology Department of Obstetrics and Gynecology, Barzilai Medical Center Campus, Ben-Gurion University, Ashkelon, Israel.

Journal Details

This article was published in the following journal.

Name: Echocardiography (Mount Kisco, N.Y.)
ISSN: 1540-8175
Pages:

Links

• PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22694148
• DOI: http://dx.doi.org/10.1111/j.1540-8175.2012.01745.x