Left Ventricular And Carotid Arterial Adaptations In Pregnancy Women Assessed By Wave Intensity And Echocardiography

Background: In order to the need of fetal growth, normal pregnancy induces a variety of cardiovascular adaptations. In the absence of these adaptations, gestational complications reportedly increase. So far, there is a few report at home and abroad that study adaptations of heart and artery simultaneously in normal pregnancy women. Wave intensity is a new technique that investigate hemodynamics about working condition of the heart interacting with the arterial system. At present, Wave intensity have main application in research field. Wave intensity can provide helpful information about hemodynamics on work condition of the heart interacting with the arterial system. Wave intensity can provide a new approach that study adaptations of heart and artery simultaneously in normal pregnancy women.Objective: To measure left ventricular and carotid arterial function in normal pregnancy women by wave intensity and echocardiograph. To find out left ventricular and carotid arterial adaptation in normal pregnancy women. To investigate the clinical value of wave intensity in evaluation of left ventricular and carotid function in normal pregnancy.Methods: Ninety pregnancy women including thirty early, middle and late pregnancy respectively. Thirty healthy women served as the control. All observation objects were detected blood pressure and recorded heart rate firstly. Selected Adult Heart process and sweeped heart, then, received left ventricular function parameters (cardiac output, cardiac index, stroke volume, left ventricular ejection fraction, left ventricular fractional shortening, peak early diastolic velocity of mitral flow, peak late diastolic velocity of mitral flow and ratio of late tow) . Selected WI process and sweeped common carotid artery, then, received WI parameters ( transient acceleration wave intensity and transient deceleration wave intensity) and arterial elastic parameters ( carotid arterial stiffness index and compliance). Lately, the correlation among some parameters were analyzed.Results: Heart rate ,cardiac output and cardiac index increased significantly throughout pregnancy, peaked in late pregnancy (p <0.01) . Stroke volume increased predominantly in middle and late pregnancy, peaked in late pregnancy (p <0.01) . Left ventricular ejection fraction and left ventricular fractional shortening were no statistical significance between healthy women and normal pregnancy women (p >0.05 ) . E/A ratio decreased significantly in late pregnancy (p <0.05) . Transient deceleration wave intensity and transient acceleration wave intensity were no statistical significance between healthy women and normal pregnancy women ( p >0.05 ) . Carotid arterial stiffness index increased predominantly in middle and late pregnancy, peaked in late pregnancy (p <0.01) . Carotid arterial compliance decreased predominantly in middle and late pregnancy. Carotid arterial compliance reached lowest value in late pregnancy (p<0.01). Coefficient of determination between cardiac output and stroke volume equaled 0.5684 in middle pregnancy (p <0.01). Coefficient of determination between cardiac output and stroke volume equaled 0.6218 in late pregnancy (p <0.01) .Conclusion: Cardiac output increases in early pregnancy, initially as a result of an increased heart rate. Increased cardiac output in middle and late pregnancy owe mainly to stroke volume. Although cardiac output and stroke volume increase during pregnancy, left ventricular systolic function changes slightly. Left ventricular diastolic function changes in late pregnancy. Left ventricular behavior during the period from late systole to isovolumic relaxation changes slightly throughout pregnancy. Stiffness index of carotid artery increases and arterial compliance of carotid artery decreases during pregnancy. Left ventricular and carotid arterial adaptations in normal pregnancy women can be reflected by carotid arterial wave intensity. Carotid arterial wave intensity may be applied to clinical monitoring the cardiovascular system in pregnancy women.