{"title":"妊娠期呼吸困难可能与心脏生理适应不完全有关。","authors":"Atoosa Mostafavi, Mona Feizian, Seyedeh Zahra Fotook Kiaei, Seyed Abdolhussein Tabatabaei","doi":"10.34172/jcvtr.2022.30539","DOIUrl":null,"url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Dyspnea is a common complaint in pregnant women with no cardiac and pulmonary diseases. We aimed to assess whether physiological dyspnea of pregnancy was correlated with subtle changes in ventricular systolic and diastolic function. <b><i>Methods:</i></b> This cross-sectional study enrolled 40 healthy pregnant women in their second and third trimesters with no complaints of dyspnea and 40 healthy pregnant women in the same trimesters with a complaint of dyspnea. Parameters of echocardiography were compared between the 2 groups. <b><i>Results:</i></b> Global left ventricular ejection fraction (59.65±6.44 and 58.49±4.95 <i>P</i>=0.418 in patients without and with dyspnea respectively), and global longitudinal strain were not significantly different (18.72±2.90 and 18.94±3.07, <i>P</i>=0.57 in the same order). Global circumferential strain (GCS) was lower in patients with dyspnea. (20.19±4.86 vs 22.61±4.69, <i>P</i>=0.03). Systolic volume (33.17±8.94 vs 32.63±8.09) and diastolic volume (80.75±18.73 vs 78.37±16.63) and left ventricular end-diastolic diameter (47.5±4.24 vs 46.23±3.21) were not different (<i>P</i>=0.784, 0.560 and 0.146 respectively). Left ventricular end-systolic diameter was significantly lower in the case group (32.52±4.66 vs 29.92±4.05, <i>P</i>=0.011). Left atrial area index in the patients with dyspnea was lower(8.13±1.42 vs 8.94±1.4, <i>P</i>=0.014). Other findings were a high E/E' and high pulmonary artery pressure in the patients with dyspnea. <b><i>Conclusion:</i></b> Dyspnea in pregnant women can be a consequence of incomplete physiological adaptation to volume overload in pregnancy. Lower systolic and diastolic diameters of the left ventricle, left atrial area, and left atrial index may lead to increased filling pressure, manifested by a higher E/E' ratio and pulmonary artery pressure.</p>","PeriodicalId":15207,"journal":{"name":"Journal of Cardiovascular and Thoracic Research","volume":"14 4","pages":"228-233"},"PeriodicalIF":1.2000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9871158/pdf/","citationCount":"0","resultStr":"{\"title\":\"Dyspnea in pregnancy might be related to the incomplete physiological adaptation of the heart.\",\"authors\":\"Atoosa Mostafavi, Mona Feizian, Seyedeh Zahra Fotook Kiaei, Seyed Abdolhussein Tabatabaei\",\"doi\":\"10.34172/jcvtr.2022.30539\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b><i>Introduction:</i></b> Dyspnea is a common complaint in pregnant women with no cardiac and pulmonary diseases. We aimed to assess whether physiological dyspnea of pregnancy was correlated with subtle changes in ventricular systolic and diastolic function. <b><i>Methods:</i></b> This cross-sectional study enrolled 40 healthy pregnant women in their second and third trimesters with no complaints of dyspnea and 40 healthy pregnant women in the same trimesters with a complaint of dyspnea. Parameters of echocardiography were compared between the 2 groups. <b><i>Results:</i></b> Global left ventricular ejection fraction (59.65±6.44 and 58.49±4.95 <i>P</i>=0.418 in patients without and with dyspnea respectively), and global longitudinal strain were not significantly different (18.72±2.90 and 18.94±3.07, <i>P</i>=0.57 in the same order). Global circumferential strain (GCS) was lower in patients with dyspnea. (20.19±4.86 vs 22.61±4.69, <i>P</i>=0.03). Systolic volume (33.17±8.94 vs 32.63±8.09) and diastolic volume (80.75±18.73 vs 78.37±16.63) and left ventricular end-diastolic diameter (47.5±4.24 vs 46.23±3.21) were not different (<i>P</i>=0.784, 0.560 and 0.146 respectively). Left ventricular end-systolic diameter was significantly lower in the case group (32.52±4.66 vs 29.92±4.05, <i>P</i>=0.011). Left atrial area index in the patients with dyspnea was lower(8.13±1.42 vs 8.94±1.4, <i>P</i>=0.014). Other findings were a high E/E' and high pulmonary artery pressure in the patients with dyspnea. <b><i>Conclusion:</i></b> Dyspnea in pregnant women can be a consequence of incomplete physiological adaptation to volume overload in pregnancy. Lower systolic and diastolic diameters of the left ventricle, left atrial area, and left atrial index may lead to increased filling pressure, manifested by a higher E/E' ratio and pulmonary artery pressure.</p>\",\"PeriodicalId\":15207,\"journal\":{\"name\":\"Journal of Cardiovascular and Thoracic Research\",\"volume\":\"14 4\",\"pages\":\"228-233\"},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2022-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9871158/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Cardiovascular and Thoracic Research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.34172/jcvtr.2022.30539\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cardiovascular and Thoracic Research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.34172/jcvtr.2022.30539","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
简介:呼吸困难是无心肺疾病孕妇的常见主诉。我们的目的是评估怀孕的生理性呼吸困难是否与心室收缩和舒张功能的细微变化相关。方法:本横断面研究招募了40名无呼吸困难主诉的妊娠中期和晚期健康孕妇,以及40名同样妊娠期有呼吸困难主诉的健康孕妇。比较两组超声心动图参数。结果:整体左室射血分数(59.65±6.44,58.49±4.95,P=0.418)和整体纵向应变(18.72±2.90,18.94±3.07,P=0.57,同序)差异无统计学意义。呼吸困难患者的总周应变(GCS)较低。(20.19±4.86 vs 22.61±4.69,P=0.03)。收缩期容积(33.17±8.94 vs 32.63±8.09)、舒张期容积(80.75±18.73 vs 78.37±16.63)、左室舒张末期内径(47.5±4.24 vs 46.23±3.21)差异无统计学意义(P值分别为0.784、0.560、0.146)。病例组左室收缩末期内径明显低于对照组(32.52±4.66 vs 29.92±4.05,P=0.011)。呼吸困难组左房面积指数较低(8.13±1.42 vs 8.94±1.4,P=0.014)。其他发现是呼吸困难患者的高E/E'和高肺动脉压。结论:孕妇呼吸困难可能是妊娠期对容积负荷不完全生理适应的结果。左心室收缩期和舒张期直径、左房面积和左房指数降低可导致充盈压力升高,表现为E/E′比和肺动脉压升高。
Dyspnea in pregnancy might be related to the incomplete physiological adaptation of the heart.
Introduction: Dyspnea is a common complaint in pregnant women with no cardiac and pulmonary diseases. We aimed to assess whether physiological dyspnea of pregnancy was correlated with subtle changes in ventricular systolic and diastolic function. Methods: This cross-sectional study enrolled 40 healthy pregnant women in their second and third trimesters with no complaints of dyspnea and 40 healthy pregnant women in the same trimesters with a complaint of dyspnea. Parameters of echocardiography were compared between the 2 groups. Results: Global left ventricular ejection fraction (59.65±6.44 and 58.49±4.95 P=0.418 in patients without and with dyspnea respectively), and global longitudinal strain were not significantly different (18.72±2.90 and 18.94±3.07, P=0.57 in the same order). Global circumferential strain (GCS) was lower in patients with dyspnea. (20.19±4.86 vs 22.61±4.69, P=0.03). Systolic volume (33.17±8.94 vs 32.63±8.09) and diastolic volume (80.75±18.73 vs 78.37±16.63) and left ventricular end-diastolic diameter (47.5±4.24 vs 46.23±3.21) were not different (P=0.784, 0.560 and 0.146 respectively). Left ventricular end-systolic diameter was significantly lower in the case group (32.52±4.66 vs 29.92±4.05, P=0.011). Left atrial area index in the patients with dyspnea was lower(8.13±1.42 vs 8.94±1.4, P=0.014). Other findings were a high E/E' and high pulmonary artery pressure in the patients with dyspnea. Conclusion: Dyspnea in pregnant women can be a consequence of incomplete physiological adaptation to volume overload in pregnancy. Lower systolic and diastolic diameters of the left ventricle, left atrial area, and left atrial index may lead to increased filling pressure, manifested by a higher E/E' ratio and pulmonary artery pressure.