Key result
Pregnancy induces subtle, reversible RV changes, though perinatal risk factors alter RV diastolic function.
Why the study?
Information on right cardiac remodelling during gestation is limited, motivating characterisation of pregnancy- and postpartum-induced right cardiovascular remodelling and reverse remodelling, including the impact of perinatal cardiovascular risk factors.
How do pregnancy, postpartum, and perinatal cardiovascular risk factors affect right heart echocardiographic parameters?
Cohort (n=130)
Yes
How do pregnancy, postpartum, and perinatal cardiovascular risk factors affect right heart echocardiographic parameters?
Answers are grounded in this paper and cite their sources.
Pregnancy induces physiological right heart remodeling that normalizes by 6 months postpartum, though perinatal cardiovascular risk factors subtly alter myocardial deformation and diastolic function.
BACKGROUND: Considering the limited information available on right cardiac remodelling during gestation, we aimed to characterise the right cardiovascular (CV) remodelling and reverse remodelling (RR) induced by pregnancy and postpartum, respectively, and the impact of perinatal CV risk (CVR) factors on these processes. METHODS: This prospective cohort was recruited at two tertiary centres during 2019-2022, including 51 healthy pregnant women and 79 with perinatal CVR factors. Participants were evaluated by transthoracic echocardiography during pregnancy (1st[1T] and 3rd[3T] trimesters) and postpartum (one-month[PP1], six-months[PP2], and one-year postpartum[PP3]). Generalised linear mixed-effects models were used for statistical analysis. RESULTS: Similar enlargement of the right atrium (RA) and right ventricle (RV) dimensions was observed throughout pregnancy, normalising at PP2 values similar to PT1. This anatomical postpartum recovery was accompanied by an increase of RV global longitudinal strain, being statistically significant in perinatal CVR group. Interestingly, at 3T, this group revealed lower RV and RA strain compared to healthy participants. Despite both groups maintained preserved RV systolic function from 1T to PP3, a significant reduction of TAPSE and tricuspid S' velocity was observed at PP1. Concomitantly, all participants showed a significant increase of E/A at the same time-point, suggesting the recovery of diastolic deterioration seen from 1T to 3T that was persistingly higher in the perinatal CVR group througout the postpartum. Constant pulmonary artery systolic pressure (PASP) was documented throughout follow-up time, showing consistently higher values in the perinatal CVR group. All these echocardiographic index changes were within the normality range. CONCLUSION: This study described subtle right cardiac changes within the normal/physiological range, recovering six-months after delivery. Coexisting perinatal CVR factors seem to affect the magnitude of RV diastolic function changes, PASP and myocardial deformation without any impact on other RV systolic function indexes.
No takes yet. Share an insight, caveat, or question.
Ferreira et al. (2024) conducted a cohort in Pregnancy and postpartum right cardiac remodelling (n=130). Pregnancy and postpartum (exposure) vs. Healthy pregnant women vs pregnant women with perinatal CVR factors was evaluated on Right cardiovascular remodelling and reverse remodelling (echocardiographic parameters). Pregnancy induces subtle right cardiac changes within the normal range that recover six months postpartum, though perinatal cardiovascular risk factors affect RV diastolic function and deformation.
Synapse has enriched 10 related papers. Consider them for comparative context: