Women with twin pregnancies exhibited significantly lower left ventricular global longitudinal strain and a more spherical left ventricular shape compared to female athletes, indicating different patterns of cardiac remodeling.
Case-Control (n=71)
No
Does cardiac remodeling differ between female athletes and women with twin pregnancies?
Cardiac remodeling in twin pregnancy differs from athlete's heart by exhibiting a more spherical left ventricular shape and altered global longitudinal strain, suggesting potential initial maternal cardiovascular maladaptation in the third trimester.
Absolute Event Rate: -23.7% vs -26.5%
p-value: p=0.02
OBJECTIVES: The aim of this study was to detect possible differences in reversible cardiac remodeling occurring in sport training and twin pregnancy. BACKGROUND: cardiac remodeling occurs in athletes and pregnant women due to training and fetal requirements, respectively. These changes could be apparently similar. METHODS: 21 female elite athletes (23.2 ± 5.3 years), 25 women with twin pregnancies (35.4 ± 5.7 years) and 25 healthy competitive female athletes (controls), age-matched with pregnant women (34.9 ± 7.9 years), were enrolled. This latter group was included to minimize the effect of age on cardiac remodeling. All women evaluated through anamnestic collection, physical examination, 12 leads ECG, standard echocardiogram and strain analysis. Sphericity (SI) and apical conicity (ACI) indexes were also calculated. RESULTS: Pregnant women showed higher LA dimension (p < 0.001) compared to both groups of athletes. LV e RV GLS were significantly different in pregnant women compared to female athletes (p = 0.02 and 0.03, respectively). RV GLS was also different between pregnant women and controls (p = 0.02). Pregnant women showed significantly higher S' wave compared to female athletes (p = 0.02) but not controls. Parameters of diastolic function were significantly higher in athletes (p = 0.08 for IVRT and p < 0.001 for E/A,). SI was lower in athletes in both diastole (p = 0.01) and systole (p < 0.001), while ACIs was lower in pregnant women (p = 0.04). CONCLUSIONS: Cardiac remodeling of athletes and pregnant women could be similar at first sight but different in LV shape and in GLS, highlighting a profound difference in longitudinal deformation between athletes and pregnant women. This difference seems not to be related with age. These findings suggest that an initial maternal cardiovascular maladaptation could occur in the third trimester of twin pregnancies.
Toncelli et al. (2022) conducted a case-control in Cardiac remodeling (n=71). Twin pregnancy vs. Elite and competitive female athletes was evaluated on Left ventricular global longitudinal strain (LV GLS) (p=0.02). Women with twin pregnancies exhibited significantly lower left ventricular global longitudinal strain and a more spherical left ventricular shape compared to female athletes, indicating different patterns of cardiac remodeling.