Staelens Anneleen S, Vonck Sharona, Mesens Tinne, Tomsin Kathleen, Molenberghs Geert, Gyselaers Wilfried
Department Obstetrics & Gynaecology, Ziekenhuis Oost Limburg, Genk, Belgium.
Department of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.
Clin Exp Pharmacol Physiol. 2015 Oct;42(10):1036-44. doi: 10.1111/1440-1681.12463.
Posture changes may differ between types of hypertensive disease. The aim is to evaluate the orthostatic response of impedance cardiography (ICG) measurements in uncomplicated and hypertensive pregnancies. Measurements were performed in supine and standing position in 202 women: 41 uncomplicated pregnancies (UP), 59 gestational hypertension (GH), 35 early-onset (EPE, < 34 weeks) and 67 late-onset (LPE, ≥ 34 weeks) preeclampsia were assessed. Measurements were recorded of heart rate, blood pressure, aortic flow parameters, cardiac output, pre-ejection period and left ventricular ejection time. Overall, orthostatic shifts were different between all groups (P < 0.001). UP was different from the hypertensive complicated gestations in the orthostatic change of the aortic acceleration. In contrast to patients with preeclampsia, those with GH had an increased blood pressure and Heather index, and stable pre-ejection period after posture change. EPE differed from LPE by change in blood pressure and aortic flow parameters. In addition to static ICG-measurements, orthostatic shifts improved group characterization from 57.4% to 65.8%. The orthostatic response is altered in hypertensive pregnancies. ICG measurements in the upright as well as during an orthostatic test might have the potential to improve the discriminative yield between hypertensive diseases in pregnancy.
不同类型的高血压疾病，其姿势变化可能有所不同。目的是评估单纯性妊娠和高血压妊娠中阻抗心动图（ICG）测量的直立位反应。对202名女性在仰卧位和站立位进行测量：评估了41例单纯性妊娠（UP）、59例妊娠期高血压（GH）、35例早发型（EPE，<34周）和67例晚发型（LPE，≥34周）子痫前期。记录心率、血压、主动脉血流参数、心输出量、射血前期和左心室射血时间的测量值。总体而言，所有组之间的直立位变化不同（P<0.001）。在主动脉加速度的直立位变化方面，UP与高血压合并妊娠不同。与子痫前期患者相比，GH患者血压和希瑟指数升高，姿势改变后射血前期稳定。EPE与LPE在血压和主动脉血流参数变化方面存在差异。除了静态ICG测量外，直立位变化将组间特征区分率从57.4%提高到了65.8%。高血压妊娠时直立位反应会发生改变。直立位以及直立位试验期间的ICG测量可能有潜力提高妊娠高血压疾病之间的鉴别诊断率。
