1. Cardiac remodelling and reverse remodelling in pregnant women: what can be expected?
- Author
-
A F Ferreira, M J Azevedo, T Proenca, F A Saraiva, A P Machado, C Sousa, B Sampaio Maia, A Leite-Moreira, C Ramalho, and I Fa
- Subjects
Cardiology and Cardiovascular Medicine - Abstract
Introduction Hemodynamic overload during pregnancy induces cardiac remodelling which is characterized by left ventricle (LV) eccentric hypertrophy and left-atrium enlargement.After delivery,the woman's heart undergoes reverse remodelling and myocardial performance normalize to their pre-gravid structure and function. Aim To characterize cardiac remodelling and reverse remodelling during pregnancy and postpartum, respectively, as well as to investigate the impact of cardiovascular (CV) risk factors in these processes. Methods This prospective cohort study included volunteer pregnant women recruited in a tertiary centre between 2019 and 2020.Women were evaluated by transthoracic echocardiography and pulse wave velocity at the 1st trimester [1T, baseline], 3rd trimester [3T, peak of CV remodelling] of pregnancy as well as at the 1st month and 6th month after delivery (reverse remodelling). Mann-whitney,wilcoxon and Ffriedman test were used as appropriate to between and within groups comparisons. Bonferroni correction was applied. Spearman correlation was performed to determine the relationship between pulse wave velocity (PWV) and echocardiographic variables. Results We included 32 pregnant women with a median age of 34 [26; 41] years, 50% being hypertensive and/or obese. The pregnant women tended to develop eccentric hypertrophy pattern during pregnancy, characterized by significant increase of cardiac mass index (CMi) from 1T to 3T (table 1, p=0.006) and slight modification of relative wall thickness (RWT, table 1, p=0.339). During postpartum, hypertrophy regression became significant only at 6 months after delivery (CMi: table 1, p Conclusion In our cohort, complete reverse remodelling occurs as soon as one month after delivery, with the exception of hypertrophy.The positive correlation between relative wall thickness and pulse wave velocity highlighted arterial-ventricular coupling relevance for the cardiac remodelling process during pregnancy. Pregnant women with CV risk factors showed higher relative wall thickness when compared with healthy women at all time points of the follow-up. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Universidade do Porto/FMUP and FSE-Fundo Social Europeu; FCT - Foundation for Science and Technology
- Published
- 2021
- Full Text
- View/download PDF