Impact of Gestational Hypertension on Left Ventricular Function and Geometric Pattern

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概要

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• Background: The effect of gestational hypertension on left ventricular (LV) function in previously normotensive young women has not been evaluated. Methods and Results: A total of 106 gestational hypertensive women (GHW, 32.3±4.2 years) and 93 normotensive pregnant women (NPW, 30.2±4.4 years) were enrolled. Transthoracic echocardiography, including 2-dimensional strain echocardiography, was done and myocardial performance (Tei index), LV mass index (LVMI), and relative wall thickness (RWT) were analyzed. GHW had significantly increased wall thickness (interventricular septum, 9.5±0.9mm vs. 8.8±1.0mm, P<0.001; posterior wall, 9.0±1.1mm vs. 8.5±1.1mm, P=0.007; and RWT, 0.39±0.06 vs. 0.35±0.05, P=0.02), higher LVMI (95.6±17.3g/m2 vs. 86.1±14.5g/m2, P=0.03), longer isovolumetric relaxation time (117.7±18.2ms vs. 82.3±12.6ms, P=0.003), lower E/A ratio (1.00±0.29 vs. 1.27±0.33, P=0.002), and higher Tei index (0.48±0.23 vs. 0.33±0.13, P=0.003) compared to NPW. Global longitudinal LV strain, representing LV systolic function, was also significantly reduced in GHW compared with NPW (-17.6±2.95% vs. -21.2±2.14%, P=0.02). A total of 62% of GHW (n=66) had abnormal geometry, of whom, 42 (40%) had eccentric hypertrophy (EH). A total of 93% of NPW (n=86) had normal geometry, and only 7 NPW (7%) had abnormal geometry. Conclusions: GHW had aggravated diastolic and longitudinal systolic dysfunction. GHW had increased LVMI with the abnormal geometric pattern of EH. The reversibility of these morphological and functional impairments after delivery needs to be clarified. (Circ J 2011; 75: 1170-1176)

• 2011-04-25

著者

• Yoon Se-jung

  Division Of Cardiology Nhic Ilsan Hospital

• Yoon Se-jung

  Division Of Cardiology Department Of Laboratory Medicine Yonsei University College Of Medicine

• Choi Jung-hyun

  Division Of Cardiology Dankook University

• Shin Sung-hee

  Division Of Cardiology College Of Medicine Inha University

• Kim Seong-man

  Division Of Cardiology Maryknoll Medical Center

• Cho Eun-joo

  Division Of Cardiology Catholic University St Paul's Hospital

• CHO Kyoung-Im

  Division of Cardiology, Maryknoll Medical Center

• SHIN Mi-Seung

  Division of Cardiology, Gachon University, Gil Hospital

• KIM Eui-Joo

  Division of Cardiology, Gachon University, Gil Hospital

• SEO Hae-Sun

  Division of Cardiology, Soonchunhyang University

• Seo Hae-sun

  Division Of Cardiology Soonchunhyang University

• Kim Eui-joo

  Division Of Cardiology Gachon University Gil Hospital

• Shin Mi-seung

  Division Of Cardiology Gachon University Gil Hospital

• Cho Kyoung-im

  Division Of Cardiology Maryknoll Medical Center

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