Quantitative cardiovascular magnetic resonance in pregnant women: cross-sectional analysis of physiological parameters throughout pregnancy and the impact of the supine position

Journal of Cardiovascular Magnetic Resonance

Research

Petra Opic¹  Jolien Roos-Hesselink¹  Alexia Rossi²  Yusuf Karamermer²  Tirza Springeling²  Robert-Jan M van Geuns²  Jerome Cornette³  Eric Steegers³  Mark R Johnson⁴  Adriaan Moelker⁵  Gabriel P Krestin⁵ 

[1] Department of Cardiology, Erasmus University Medical Center, 's Gravendijkwal 230, 3015CE, Rotterdam, The Netherlands;Department of Cardiology, Erasmus University Medical Center, 's Gravendijkwal 230, 3015CE, Rotterdam, The Netherlands;Department of Radiology, Erasmus University Medical Center, 's Gravendijkwal 230, 3015CE, Rotterdam, The Netherlands;Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus University Medical Center, 's Gravendijkwal 230, 3015CE, Rotterdam, the Netherlands;Department of Obstetrics and Gynaecology, Imperial College of Medicine, Chelsea and Westminster Hospital, London, UK;Department of Radiology, Erasmus University Medical Center, 's Gravendijkwal 230, 3015CE, Rotterdam, The Netherlands;

关键词: Cardiac Output;    Right Ventricular;    Stroke Volume;    Cardiovascular Magnetic Resonance;    Healthy Pregnant Woman;   

DOI  :  10.1186/1532-429X-13-31

 received in 2011-01-17, accepted in 2011-06-27,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundThere are physiological reasons for the effects of positioning on hemodynamic variables and cardiac dimensions related to altered intra-abdominal and intra-thoracic pressures. This problem is especially evident in pregnant women due to the additional aorto-caval compression by the enlarged uterus. The purpose of this study was to investigate the effect of postural changes on cardiac dimensions and function during mid and late pregnancy using cardiovascular magnetic resonance (CMR).MethodsHealthy non-pregnant women, pregnant women at 20th week of gestation and at 32nd week of gestation without history of cardiac disease were recruited to the study and underwent CMR in supine and left lateral positions. Cardiac hemodynamic parameters and dimensions were measured and compared between both positions.ResultsFive non-pregnant women, 6 healthy pregnant women at mid pregnancy and 8 healthy pregnant women at late pregnancy were enrolled in the study. In the group of non-pregnant women left ventricular (LV) cardiac output (CO) significantly decreased by 9% (p = 0.043) and right ventricular (RV) end-diastolic volume (EDV) significantly increased by 5% (p = 0.043) from the supine to the left lateral position. During mid pregnancy LV ejection fraction (EF), stroke volume (SV), left atrium lateral diameter and left atrial supero-inferior diameter increased significantly from the supine position to the left lateral position: 8%, 27%, 5% and 11%, respectively (p < 0.05). RV EDV, SV and right atrium supero-inferior diameter significantly increased from the supine to the left lateral position: 25%, 31% and 13% (p < 0.05), respectively. During late pregnancy a significant increment of LV EF, EDV, SV and CO was observed in the left lateral position: 11%, 21%, 35% and 24% (p < 0.05), respectively. Left atrial diameters were significantly larger in the left lateral position compared to the supine position (p < 0.05). RV CO was significantly increased in the left lateral position compared to the supine position (p < 0.05).ConclusionsDuring pregnancy positional changes affect significantly cardiac hemodynamic parameters and dimensions. Pregnant women who need serial studies by CMR should be imaged in a consistent position. From as early as 20 weeks the left lateral position should be preferred on the supine position because it positively affects venous return, SV and CO.

【 授权许可】

Unknown   
© Rossi et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.