Normal Echocardiographic Measurements in Uncomplicated Pregnancy, a Single Center ExperienceGeoffrey J. Tso, Jennifer M. Lee, Nada M. Shaban, George K. Lui, Heather A. Trivedi,Martin N. Cohen, Peter S. Bernstein, Cynthia C. Taub.
Background: Cardiovascular changes of pregnancy are well-known; however, parameters for accurately assessing these
changes have not been refi ned as measurement tools have advanced. We sought to examine the range of echocardiographic
parameters during normal pregnancy using current echocardiographic imaging modalities. Methods: We performed a
retrospective analysis of normal echocardiograms in 121 women (97 pregnant, 24 non-pregnant) without evidence of
cardiovascular disease. Linear, area, and Doppler fl ow measurements were made of commonly reviewed cardiac structures.
Height-indexed measurements were compared between pregnant women and controls and between trimesters of pregnancy.
Results: Compared to non-pregnant patients, all four cardiac chambers showed signifi cant enlargement in the pregnant
patients. The left atrium was the fi rst chamber to enlarge. LV mass also increased in the third trimester (134.5 ± 31 vs.
112.3 ± 28.2 g, P < 0.01), with preservation of LV mass to volume ratio. LV ejection fraction was signifi cantly larger (68%
vs. 63%, P < 0.036) in the second trimester patients, but decreased into the third trimester (64.1% ± 6.8%, P < 0.006). When
pulmonary artery systolic pressure (PASP) was calculated from the pulmonary artery acceleration time, observed pressures
were signifi cantly greater in the third trimester than second trimester (40.1 ± 10.3 vs. 45.5 ± 10.1 mmHg, P = 0.029). PASP
calculated conventionally from tricuspid regurgitation gradient did not show similar signifi cance. There was no signifi cant
change in diastolic parameters throughout pregnancy. Conclusions: This study provides data on echocardiographic parameters
during normal pregnancy and is one of the largest sample sizes in the literature. The results will contribute to the current
literature by helping to distinguish between normal and abnormal echocardiograms during pregnancy.
Chamber quantifi cations, echocardiography, pregnancy
American Journal of Physiology, Biochemistry and Pharmacology
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