Physiologic multivalvular regurgitation during pregnancy: a longitudinal Doppler echocardiographic study
| Autor: | Jose Bocanegra, Antonio Carlos Carvalho, José L. Andrade, John A. Ambrose, Eulogio E. Martinez, Keiko Harada, Orlando Campos |
|---|---|
| Rok vydání: | 1993 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent Cardiac Volume Pregnancy Complications Cardiovascular Heart Valve Diseases Gestational Age Regurgitation (circulation) Doppler echocardiography Tricuspid Valve Insufficiency Pregnancy Reference Values Internal medicine medicine Humans Prospective Studies cardiovascular diseases Heart valve Mitral regurgitation medicine.diagnostic_test business.industry Hemodynamics Mitral Valve Insufficiency Gestational age medicine.disease Heart Valves Echocardiography Doppler Pulmonary Valve Insufficiency Surgery medicine.anatomical_structure cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business Blood Flow Velocity |
| Zdroj: | International Journal of Cardiology. 40:265-272 |
| ISSN: | 0167-5273 |
| Popis: | Valvular function, assessed by Doppler technique, has not been extensively investigated during normal pregnancy. To prospectively study this feature, 18 normal pregnant women were followed during their pregnancies and puerperium, with serial clinical and pulsed-continuous Doppler echocardiographic examinations. In four gestational periods and the puerperium, we analysed: (a) ventricular and atrial dimensions, as well as valve annular diameters; (b) prevalence and characteristics of trivial valvular regurgitations. During pregnancy, slight but significant increases of the four cardiac chamber dimensions and valve annular diameters were observed, except for the aortic ring. The prevalence of physiologic valvular regurgitation in early pregnancy (mitral, 0%; tricuspid, 38.9%; pulmonary, 22.2%; aortic, 0%), was similar to a control group of 18 healthy non-pregnant women. As pregnancy evolved, there was a progressive and significant increase of multivalvular regurgitation, maximal at full-term (mitral, 27.8%; tricuspid, 94.4%; pulmonary, 94.4%, P < 0.05 vs. early pregnancy). Aortic regurgitation was not detected in any stage of pregnancy. In the puerperium, mitral regurgitation resolved, but tricuspid and pulmonary regurgitation were still significantly prevalent (83.3% and 66.7%, respectively, P < 0.05 vs. early pregnancy). It is concluded that physiologic multivalvular regurgitation is frequent in pregnancy, mainly involving right-sided valves in late gestational periods, occasionally persisting in the early puerperium. Chamber enlargement, valve annular dilatation, and increased prevalence of trivial valve regurgitation are time-related events during normal pregnancy, resulting from a reversible cardiac remodeling process induced by physiologic volume overload. These aspects should be considered for a correct interpretation of Doppler echocardiographic findings in pregnant women with suspected heart disease. |
| Databáze: | OpenAIRE |
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