R-Pulse Wave Arrival Timing with Cardiac Diseases in Pregnancy

Pulse wave arrival time (PWAT) can be measured noninvasively by using the R-wave of the electrocardiogram and the peripheral pressure pulse. This report describes our preliminary observations in the use of this physiologic parameter to study a group of 12 pregnant patients with a history of cardiac disease. Their PWATs were compared to those recorded from normal, uncomplicated pregnant women, which were reported previously. All patients were clinically stable and without signs or symptoms of congestive heart failure. In seven patients the PWAT was either normal or shortened; the latter occurred in three patients whose pregnancies were complicated by hypertension. The PWAT was prolonged in all five cases with positive laboratory evidence of cardiac compromise. These data suggest that the PWAT may be a useful screening adjunct in the diagnosis and management of early cardiac dysfunction, but does not supplant the need for conventional cardiac evaluation methods.