Year: 2024
Type: editorial
Abstract: ardiovascular adaptive changes during normal pregnancy have been well studied and include a reduction in systemic vascular resistance and blood pressure and an increase in cardiac output, heart rate, and plasma volume. 1 Changes in myocardial contractility that occur during each trimester and in the postpartum period [1][2][3] are not as well understood.Unfortunately, there is no easy way to measure contractility clinically.It is well known that left ventricular (LV) ejection fraction (EF) is influenced by changes in preload, afterload, and contractility, which can be further assessed by measuring LV volumes and geometry.Echocardiography is the principal means of studying cardiovascular structure and function in all patients, regardless of pregnancy status.Adaptive cardiac changes that are easily seen on echocardiography include an increase in chamber size, LV mass, and cardiac output.However, LVEF, fractional shortening, and most parameters of diastolic function do not appear to change significantly during pregnancy.4,5 Accordingly, a few studies have employed deformation imaging such as strain and strain rate during pregnancy with the goal of detecting subclinical LV dysfunction before an observed decline in LVEF to provide opportunities for early clinical intervention.6 Similarly, while 3 dimensional (3D) measurements have continuously proven superior to 2 dimensional methods for volume quantitation, in experienced hands, 7 these newer techniques have experienced slow adoption into clinical practice for all patients.
Source: JACC Advances
Authors: Colleen M. Harrington, Varsha Tanguturi, Rachel Goldberg
Institution: Massachusetts General Hospital
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,850
OpenAlex ID: W4404790059