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Effect of physiological overload on pregnancy in women with mitral regurgitation.

Borges VT, Matsubara BB, Magalhães CG, Peraçoli JC, Rudge MV - Clinics (Sao Paulo) (2011)

Bottom Line: Twelve age-matched healthy and pregnant women were included as controls and underwent the same evaluation as the study group.At the end of the puerperium, women with mitral regurgitation showed persistent enlargement of the left atrium compared with the beginning of pregnancy (5.0 ± 1.1 cm vs 4.6 ± 0.9 cm; p < 0.05).Pregnancy causes unfavorable structural alterations in women with mitral regurgitation that are associated with an aggravation of the hemodynamic overload.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynaecology, Botucatu Medical School, São Paulo State University, Botucatu, São Paulo, Brazil. vborges@fmb.unesp.br

ABSTRACT

Objectives: to evaluate the structural and functional heart abnormalities in women with mitral regurgitation during pregnancy.

Introduction: Women with mitral regurgitation progress well during pregnancy. However, the effects on the heart of the association between pregnancy and mitral regurgitation are not well established.

Methods: This is a case-control, longitudinal prospective study. Echocardiograms were performed in 18 women with mitral regurgitation at the 12th and 36th week of pregnancy and on the 45th day of the puerperium. Twelve age-matched healthy and pregnant women were included as controls and underwent the same evaluation as the study group.

Results: Compared with controls, women with mitral regurgitation presented increased left cardiac chambers in all evaluations. Increasing left atrium during pregnancy occurred only in the mitral regurgitation group. At the end of the puerperium, women with mitral regurgitation showed persistent enlargement of the left atrium compared with the beginning of pregnancy (5.0 ± 1.1 cm vs 4.6 ± 0.9 cm; p < 0.05). Reduced left ventricular relative wall thickness (0.13 ± 0.02 vs 0.16 ± 0.02; p < 0.05) and an increased peak of afterload (278 ± 55 g/cm² vs 207 ± 28 g/cm²; p < 0.05) was still observed on the 45th day after delivery in the mitral regurgitation group compared with controls.

Conclusions: Pregnancy causes unfavorable structural alterations in women with mitral regurgitation that are associated with an aggravation of the hemodynamic overload.

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Related in: MedlinePlus

Relative wall thickness obtained by echocardiograms during the protocol study.
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f1-cln_66p47: Relative wall thickness obtained by echocardiograms during the protocol study.

Mentions: Table 2 and Figure 1 show the LV geometry data in the groups. The left atrium diameter (LAD), LVDD and LV mass were higher in the MR group in all evaluations. Pregnancy caused additional increases in the left atrium diameter only in the MR group. An increase in the relative wall thickness occurred in both groups during pregnancy. However, compared with controls, the MR group presented a decreased relative wall thickness during the puerperium, suggesting ventricular dilation (Figure 1).


Effect of physiological overload on pregnancy in women with mitral regurgitation.

Borges VT, Matsubara BB, Magalhães CG, Peraçoli JC, Rudge MV - Clinics (Sao Paulo) (2011)

Relative wall thickness obtained by echocardiograms during the protocol study.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3044572&req=5

f1-cln_66p47: Relative wall thickness obtained by echocardiograms during the protocol study.
Mentions: Table 2 and Figure 1 show the LV geometry data in the groups. The left atrium diameter (LAD), LVDD and LV mass were higher in the MR group in all evaluations. Pregnancy caused additional increases in the left atrium diameter only in the MR group. An increase in the relative wall thickness occurred in both groups during pregnancy. However, compared with controls, the MR group presented a decreased relative wall thickness during the puerperium, suggesting ventricular dilation (Figure 1).

Bottom Line: Twelve age-matched healthy and pregnant women were included as controls and underwent the same evaluation as the study group.At the end of the puerperium, women with mitral regurgitation showed persistent enlargement of the left atrium compared with the beginning of pregnancy (5.0 ± 1.1 cm vs 4.6 ± 0.9 cm; p < 0.05).Pregnancy causes unfavorable structural alterations in women with mitral regurgitation that are associated with an aggravation of the hemodynamic overload.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynaecology, Botucatu Medical School, São Paulo State University, Botucatu, São Paulo, Brazil. vborges@fmb.unesp.br

ABSTRACT

Objectives: to evaluate the structural and functional heart abnormalities in women with mitral regurgitation during pregnancy.

Introduction: Women with mitral regurgitation progress well during pregnancy. However, the effects on the heart of the association between pregnancy and mitral regurgitation are not well established.

Methods: This is a case-control, longitudinal prospective study. Echocardiograms were performed in 18 women with mitral regurgitation at the 12th and 36th week of pregnancy and on the 45th day of the puerperium. Twelve age-matched healthy and pregnant women were included as controls and underwent the same evaluation as the study group.

Results: Compared with controls, women with mitral regurgitation presented increased left cardiac chambers in all evaluations. Increasing left atrium during pregnancy occurred only in the mitral regurgitation group. At the end of the puerperium, women with mitral regurgitation showed persistent enlargement of the left atrium compared with the beginning of pregnancy (5.0 ± 1.1 cm vs 4.6 ± 0.9 cm; p < 0.05). Reduced left ventricular relative wall thickness (0.13 ± 0.02 vs 0.16 ± 0.02; p < 0.05) and an increased peak of afterload (278 ± 55 g/cm² vs 207 ± 28 g/cm²; p < 0.05) was still observed on the 45th day after delivery in the mitral regurgitation group compared with controls.

Conclusions: Pregnancy causes unfavorable structural alterations in women with mitral regurgitation that are associated with an aggravation of the hemodynamic overload.

Show MeSH
Related in: MedlinePlus