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, 33-38weeks and 8-12weeks 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.