Maternal left ventricular diastolic and systolic long-axis function during normal pregnancy

Aims: The aim of this study was to evaluate left ventricular (LV) function during normal pregnancy and investigate the effect of maternal factors. Little information about LV diastolic and long-axis systolic function in normal pregnancy exists. Methods and results: Two hundred and twenty eight Doppler echocardiography and DTI studies of the mitral, annulus were performed in 63 normal pregnant women longitudinally at 11-14, 20-24, 26-32, 33-38 weeks and 8-12 weeks postpartum. Cardiac output, stroke volume and heart rate increased during pregnancy and total vascular resistance decreased. Long-axis shortening decreased, transmitral A velocity increased (p = 0.003) and the ratio of transmitral E to A velocity decreased (p = 0.001). DTI early diastolic velocity (E') decreased and late diastolic velocity (A') remained unaltered. DTI systolic velocity (S) and the E/E' ratio did not change significantly during pregnancy. Tei index increased throughout pregnancy (p = 0.03). Maternal age was related to E velocity (p = 0.001) and E/A ratio (p = 0.001)while ethnicity was related to cardiac output (p < 0.001), stroke volume (p < 0.02) and heart rate (p < 0.0001). Conclusion: This study gives normal ranges for Doppler tissue imaging measurements, but demonstrates that maternal characteristics may affect these and all measures of systolic and diastolic function. (c) 2007 The European Society of Cardiology. Published by Elsevier Ltd. All rights reserved.