Çağlar Fatma Nihan Turhan, Ozde Cem, Bostancı Evrim, Çağlar İlker Murat, Çiftçi Serkan, Unğan İsmail, Demir Bülent, Karakaya Osman
Bakırköy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey.
Department of Cardiology, Gaziosmanpasa Taksim Education and Research Hospital, Istanbul, Turkey.
Pregnancy Hypertens. 2016 Apr;6(2):89-94. doi: 10.1016/j.preghy.2015.12.004. Epub 2016 Apr 4.
Preeclampsia (PE) is a multisystemic disorder characterized by hypertension and proteinuria that is specific to pregnancy and associated with maternal and fetal morbidity-mortality.
To assess right heart structure and function in PE by echocardiography using conventional and tissue Doppler techniques.
In total, 67 women with untreated PE and 46 matched healthy pregnant women were included. PE was defined according to the ACOG (2002) criteria. Right and left heart functions were evaluated using transthoracic two-dimensional (2D) echocardiography with color Doppler and tissue Doppler imaging techniques.
Right ventricular basal and outflow tract diameters and free wall thickness, right atrial end-systolic maximum diameter, and area were significantly higher in the PE group than the control group (p<0.05). Tricuspid annular plane systolic excursion, isovolumic acceleration time, tissue Doppler-derived tricuspid lateral annular systolic velocity (S'), right ventricle fractional area change, and myocardial performance index (Tei) were significantly lower in the PE group than the controls (p<0.05).
PE does not only affect the left side of the heart but also the right side. This finding may open new scenarios, because right ventricular dysfunction may also be responsible for PE-related morbidity.
子痫前期(PE)是一种多系统疾病,其特征为高血压和蛋白尿,是妊娠特有的疾病,与母婴发病率和死亡率相关。
采用传统和组织多普勒技术,通过超声心动图评估子痫前期患者的右心结构和功能。
总共纳入了67例未经治疗的子痫前期女性患者和46例匹配的健康孕妇。子痫前期根据美国妇产科医师学会(2002年)标准进行定义。使用经胸二维(2D)超声心动图结合彩色多普勒和组织多普勒成像技术评估右心和左心功能。
子痫前期组的右心室基底和流出道直径、游离壁厚度、右心房收缩末期最大直径和面积均显著高于对照组(p<0.05)。子痫前期组的三尖瓣环平面收缩期位移、等容加速时间、组织多普勒测量的三尖瓣外侧环收缩期速度(S')、右心室面积变化分数和心肌性能指数(Tei)均显著低于对照组(p<0.05)。
子痫前期不仅影响心脏左侧,也影响右侧。这一发现可能开辟新的研究方向,因为右心室功能障碍也可能是子痫前期相关发病的原因。