Murat Selda, Velipasaoglu Melih, Murat Bektas, Al Aytug, Cicek Sevil, Cavusoglu Yüksel
Department of Cardiology, Medical Faculty, Eskisehir Osmangazi University.
Department of Obstetrics and Gynecology, Eskisehir Osmangazi University.
Blood Press Monit. 2023 Feb 1;28(1):42-46. doi: 10.1097/MBP.0000000000000626. Epub 2022 Dec 13.
The aim of this study was to investigate the relationship between left atrial (LA) abnormalities and ambulatory blood pressure variability (BPV) in pregnant women and their relationship with hypertension-related clinical outcomes in pregnancy.
This single-center, prospective study included 119 pregnant women. All participants underwent 24-h ambulatory blood pressure (BP) monitoring and echocardiographic examination before 20 weeks of gestation. BPV was evaluated using 24-h ambulatory BP monitoring. SD of the mean of SBP (SBP-SD) and DBP variability was calculated as 24-h, daytime and nighttime SBP and DBP. The patients were classified into two groups based on median 24-h SBP-SD (11.3 mmHg). LA features of the patients were compared according to the high and low BPV groups.
One hundred and nineteen pregnant women (mean age, 28.6 ± 5.2 years) were included in the study. The mean office SBP and DBP were 108.7 ± 15.4 mmHg and 68.2 ± 10.2 mmHg, respectively. In pregnant women with high BPV, even though BP is normal, reservoir and conduit LA functions have decreased and LA stiffness has increased. Gestational hypertension and composite outcomes were more common in pregnant women with high BPV. Among the LA parameters, the most associated with composite outcome was conduit LA function.
In pregnancy, higher BPV is associated with worse LA function. The LA conduit strain offers potential value in predicting hypertension-related clinical outcomes in pregnancy.
本研究旨在探讨孕妇左心房（LA）异常与动态血压变异性（BPV）之间的关系，以及它们与妊娠高血压相关临床结局的关系。
这项单中心前瞻性研究纳入了119名孕妇。所有参与者在妊娠20周前接受了24小时动态血压（BP）监测和超声心动图检查。使用24小时动态血压监测评估BPV。收缩压均值标准差（SBP-SD）和舒张压变异性计算为24小时、白天和夜间的收缩压和舒张压。根据24小时SBP-SD中位数（11.3 mmHg）将患者分为两组。比较高低BPV组患者的LA特征。
119名孕妇（平均年龄28.6±5.2岁）纳入研究。平均诊室收缩压和舒张压分别为108.7±15.4 mmHg和68.2±10.2 mmHg。在BPV高的孕妇中，即使血压正常，LA的储器和管道功能也会下降，LA僵硬度会增加。妊娠高血压和复合结局在BPV高的孕妇中更常见。在LA参数中，与复合结局最相关的是LA管道功能。
在妊娠中，较高的BPV与较差的LA功能相关。LA管道应变在预测妊娠高血压相关临床结局方面具有潜在价值。
