Veille J C, Hosenpud J D, Morton M J
Am J Obstet Gynecol. 1984 Nov 1;150(5 Pt 1):443-9. doi: 10.1016/s0002-9378(84)90418-6.
The physiologic cardiac enlargement characteristic of normal pregnancy could result in important left ventricular dysfunction in the presence of elevated blood pressure. Using M-mode echocardiography, we measured left ventricular dimensions, fractional shortening, and radius-to-wall thickness ratio in 23 patients who had a diagnosis of pregnancy-induced hypertension at rest and during isometric exercise. Seventeen subjects with normal pregnancies were similarly studied and served as controls. The average gestation of patients with pregnancy-induced hypertension was 38 +/- 2 weeks, and that of control subjects was 37 +/- 1 weeks. The average age was 25 +/- 5 years for patients with pregnancy-induced hypertension, and that for control subjects was 29 +/- 4 years. The patients with pregnancy-induced hypertension did not show the normal eccentric cardiac enlargement observed during pregnancy; the average radius-to-wall thickness ratio was reduced in patients with pregnancy-induced hypertension. Fractional shortening, a reflection of ventricular performance, was maintained both at rest and during exercise in the hypertensive group. One patient, who did not show a reduced radius-to-wall thickness ratio, had marked reduction of left ventricular performance in the presence of severe pregnancy-induced hypertension. Left ventricular performance in most subjects with pregnancy-induced hypertension is normal. Preservation of left ventricular performance despite increased arterial pressure may be related to the absence of eccentric gestational cardiac enlargement.
正常妊娠特有的生理性心脏增大在血压升高时可能导致重要的左心室功能障碍。我们使用M型超声心动图，对23例静息和等长运动时诊断为妊娠高血压的患者测量了左心室尺寸、缩短分数和半径与壁厚比。对17例正常妊娠的受试者进行了类似研究并作为对照。妊娠高血压患者的平均孕周为38±2周，对照受试者为37±1周。妊娠高血压患者的平均年龄为25±5岁，对照受试者为29±4岁。妊娠高血压患者未表现出妊娠期间观察到的正常离心性心脏增大；妊娠高血压患者的平均半径与壁厚比降低。缩短分数反映心室功能，在高血压组静息和运动时均保持。1例半径与壁厚比未降低的患者，在重度妊娠高血压时左心室功能明显降低。大多数妊娠高血压患者的左心室功能正常。尽管动脉压升高但左心室功能得以保留可能与缺乏离心性妊娠心脏增大有关。
