PDF(Pubmed)
Abstract：
BACKGROUND: Hemodynamic load and heart structural remodeling rise during pregnancy because these changes are physiologically necessary. Adaptations in the mother\'s circulatory system may either initiate or aggravate the development of cardiovascular disease in the offspring. If the body is unable to adjust to these changes, it may develop heart conditions like cardiomyopathy. There is a lack of third-trimester echocardiographic data on left ventricular (LV) volume and function in healthy Iraqi women. To understand the cardiac alterations that occur during normal pregnancy, a precise tool that evaluates cardiac function is needed. In that regard, the four-dimensional echocardiography (4DE) technique has markedly improved the quality and accuracy of assessing the size and function of the left ventricle.
OBJECTIVE: The present study aimed to assess LV volume and function in the third trimester of a healthy pregnancy using 4DE and to compare the results of LV assessment using 4DE with those of LV assessment using conventional two-dimensional (2D) echocardiography.
METHODS: The study was conducted on 75 healthy pregnant women (the case group) and 75 non-pregnant women (the control group). The participants attended Al-Fortat Teaching Hospital from April 1, 2022, to May 30, 2023, and had 2D and 4D echocardiographic studies performed on them.
RESULTS: The LV end-diastolic volume (EDV), end-systolic volume (ESV), and cardiac output (CO) were significantly increased in the case group compared to the control group (90.87 ± 18.03 ml vs. 62.64 ± 14.11 ml, P<0.001; 35.59 ± 6.52 ml vs. 22.42 ± 5.82 ml, P<0.001; and 4.87 ± 1.27 vs. 3.35 ± 0.87 L/m, P<0.001, respectively). In contrast, the LV ejection fraction (LVEF) was significantly decreased in the pregnant group compared to the control group (60.37 ± 5.42 % vs. 64.04 ± 4.99 %, P<0.01). Additionally, the study showed significant differences in EDV, ESV, ejection fraction (EF%), and CO (P<0.001) between 2D and 4D echocardiography, according to the Bland Altman test.
CONCLUSIONS: In healthy pregnant women in their third trimester, there is an increase in the indicators of preload (ventricular volume and CO) and a decrease in EF%. The 4DE provides detailed images and information about cardiac volumes and function, allowing for the early detection of any potential problems that may arise during pregnancy and thus improving the health outcomes of both the mother and the developing fetus.
OBJECTIVE: The present study aimed to assess LV volume and function in the third trimester of a healthy pregnancy using 4DE and to compare the results of LV assessment using 4DE with those of LV assessment using conventional two-dimensional (2D) echocardiography.
METHODS: The study was conducted on 75 healthy pregnant women (the case group) and 75 non-pregnant women (the control group). The participants attended Al-Fortat Teaching Hospital from April 1, 2022, to May 30, 2023, and had 2D and 4D echocardiographic studies performed on them.
RESULTS: The LV end-diastolic volume (EDV), end-systolic volume (ESV), and cardiac output (CO) were significantly increased in the case group compared to the control group (90.87 ± 18.03 ml vs. 62.64 ± 14.11 ml, P<0.001; 35.59 ± 6.52 ml vs. 22.42 ± 5.82 ml, P<0.001; and 4.87 ± 1.27 vs. 3.35 ± 0.87 L/m, P<0.001, respectively). In contrast, the LV ejection fraction (LVEF) was significantly decreased in the pregnant group compared to the control group (60.37 ± 5.42 % vs. 64.04 ± 4.99 %, P<0.01). Additionally, the study showed significant differences in EDV, ESV, ejection fraction (EF%), and CO (P<0.001) between 2D and 4D echocardiography, according to the Bland Altman test.
CONCLUSIONS: In healthy pregnant women in their third trimester, there is an increase in the indicators of preload (ventricular volume and CO) and a decrease in EF%. The 4DE provides detailed images and information about cardiac volumes and function, allowing for the early detection of any potential problems that may arise during pregnancy and thus improving the health outcomes of both the mother and the developing fetus.
摘要：
背景：妊娠期间血液动力学负荷和心脏结构重塑增加，因为这些变化是生理必需的。母亲循环系统的适应可能引发或加重后代心血管疾病的发展。如果身体无法适应这些变化，它可能会发展心脏病，如心肌病。在健康的伊拉克妇女中，缺乏有关左心室（LV）体积和功能的妊娠晚期超声心动图数据。为了了解正常怀孕期间发生的心脏变化，需要一种评估心脏功能的精确工具.在这方面,四维超声心动图(4DE)技术显著提高了评估左心室大小和功能的质量和准确性.
目的：本研究旨在使用4DE评估健康妊娠晚期的LV体积和功能，并将使用4DE评估LV的结果与使用常规二维（2D）超声心动图评估LV的结果进行比较。
方法：本研究对75例健康孕妇（病例组）和75例非孕妇（对照组）进行了研究。参与者于2022年4月1日至2023年5月30日在Al-Fortat教学医院就诊，并对其进行了2D和4D超声心动图研究。
结果：左心室舒张末期容积（EDV），收缩末期容积(ESV),与对照组相比，病例组和心输出量（CO）显着增加（90.87±18.03mlvs.62.64±14.11ml,P<0.001;35.59±6.52mlvs.22.42±5.82ml,P<0.001；4.87±1.27vs.3.35±0.87L/m,分别为P<0.001)。相比之下,与对照组相比，妊娠组的LV射血分数（LVEF）显着降低（60.37±5.42％vs.64.04±4.99%,P<0.01)。此外,研究表明，EDV存在显著差异，ESV,射血分数（EF％），2D和4D超声心动图之间的CO（P<0.001），根据BlandAltman的测试.
结论：在妊娠晚期的健康孕妇中，前负荷指标（心室容积和CO）增加，EF％降低。4DE提供有关心脏容积和功能的详细图像和信息，允许早期发现怀孕期间可能出现的任何潜在问题，从而改善母亲和发育中的胎儿的健康结果。
目的：本研究旨在使用4DE评估健康妊娠晚期的LV体积和功能，并将使用4DE评估LV的结果与使用常规二维（2D）超声心动图评估LV的结果进行比较。
方法：本研究对75例健康孕妇（病例组）和75例非孕妇（对照组）进行了研究。参与者于2022年4月1日至2023年5月30日在Al-Fortat教学医院就诊，并对其进行了2D和4D超声心动图研究。
结果：左心室舒张末期容积（EDV），收缩末期容积(ESV),与对照组相比，病例组和心输出量（CO）显着增加（90.87±18.03mlvs.62.64±14.11ml,P<0.001;35.59±6.52mlvs.22.42±5.82ml,P<0.001；4.87±1.27vs.3.35±0.87L/m,分别为P<0.001)。相比之下,与对照组相比，妊娠组的LV射血分数（LVEF）显着降低（60.37±5.42％vs.64.04±4.99%,P<0.01)。此外,研究表明，EDV存在显著差异，ESV,射血分数（EF％），2D和4D超声心动图之间的CO（P<0.001），根据BlandAltman的测试.
结论：在妊娠晚期的健康孕妇中，前负荷指标（心室容积和CO）增加，EF％降低。4DE提供有关心脏容积和功能的详细图像和信息，允许早期发现怀孕期间可能出现的任何潜在问题，从而改善母亲和发育中的胎儿的健康结果。
