Journal of Cardiovascular Imaging

Korean Society of Echocardiography (한국심초음파학회)
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Echocardiographic Assessment of Structural and Hemodynamic Changes in Hypertension-Related Pregnancy

  • Kim, Mi-Jeong (Division of Cardiology, Department of Internal Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea) ;
  • Seo, Jonggoo (Division of Cardiology, Department of Internal Medicine, Hallym Hospital) ;
  • Cho, Kyoung-Im (Division of Cardiology, Department of Internal Medicine, Kosin University School of Medicine) ;
  • Yoon, Se-Jung (Division of Cardiology, Department of Internal Medicine, NHIC Ilsan Hospital) ;
  • Choi, Jung-Hyun (Division of Cardiology, Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Shin, Mi-Seung (Division of Cardiology, Department of Internal Medicine, Gachon University, Gil Medical Center)
  • Received : 2015.07.03
  • Accepted : 2016.02.01
  • Published : 2016.03.27
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Abstract

Background: Pregnancy induces dramatic cardiovascular changes in order to meet the increasing metabolic needs. Adaptive change of left ventricle (LV) might be modified in pregnancy complicated by hypertension. Methods: Data from 193 consecutive pregnant women were analyzed. Clinical and echocardiographic data were compared in normotensive and hypertensive women. Results: Significantly higher LV mass indexed by height was observed in hypertensive women compared with normotensive women ($84{\pm}21g/m$ vs. $97{\pm}20g/m$, p = 0.001). Diastolic function measured by the ratio of peak velocity of early diastolic transmitral blood flow to early diastolic mitral annular velocity was impaired in hypertensive women ($11.0{\pm}3.0$ vs. $9.2{\pm}2.5$, p < 0.001). Such change was more prominent in women with gestational hypertension (GH) than those with chronic hypertension (CH). Heavy maternal weight was an independent factor associated with LV hypertrophy (LVH) in both normotensive and hypertensive women. Overt eccentric LVH was more frequent than concentric remodeling/hypertrophy (24% vs. 8.4%) in GH, while the opposite result was observed in CH (14% vs. 23%). Conclusion: Hypertensive pregnancy is associated with significant LVH and diastolic dysfunction. CH seems to induce different LV remodeling pattern from GH. Heavy maternal weight during pregnancy might intensify the unfavorable remodeling of LV, particularly in hypertensive pregnancy.

Keywords

Acknowledgement

Supported by : Korean Society of Echocardiography

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