Abdullah Arif, Hoq Sheikh, Choudhary Ronika, Laifer Steven, Zarich Stuart
Divisions of Cardiovascular Medicine and Obstetrics and Gynecology, Bridgeport Hospital, Bridgeport, and Yale University School of Medicine, New Haven, CT 06610, USA.
J Obstet Gynaecol Res. 2012 Jan;38(1):258-65. doi: 10.1111/j.1447-0756.2011.01658.x. Epub 2011 Sep 28.
To evaluate the effect of pregnancy on ventricular function in morbidly obese as compared to lean controls.
We serially studied 33 obese and non-obese pregnant females with echocardiography during each trimester of pregnancy and after delivery. Two well-validated, relatively load-independent indices of contractility (systolic shortening index and systolic velocity index) were assessed, along with more traditional echocardiographic parameters. ANOVA for repeated measures was used to compare data between sequential studies in the normal and obese pregnant groups.
In lean controls, stroke volume increased and contractility was maintained during pregnancy as compared to pre-pregnancy levels. In contrast, both stroke volume and contractility declined significantly by the third trimester in morbidly obese females.
There is a maladaptive left ventricular contractile response to pregnancy in morbidly obese patients.
评估与体重正常的对照组相比,妊娠对病态肥胖女性心室功能的影响。
我们对33名肥胖和非肥胖的怀孕女性在孕期各阶段及产后进行了连续的超声心动图研究。评估了两个经过充分验证、相对独立于负荷的收缩性指标(收缩期缩短指数和收缩期速度指数)以及更传统的超声心动图参数。采用重复测量方差分析来比较正常和肥胖孕妇组连续研究之间的数据。
与孕前水平相比,体重正常的对照组在孕期心搏量增加且收缩性维持不变。相比之下,病态肥胖女性在孕晚期心搏量和收缩性均显著下降。
病态肥胖患者对妊娠存在适应性不良的左心室收缩反应。