P6.06 SYSTEMIC ARTERIAL PROPERTIES DURING NORMAL PREGNANCIES IN HEALTHY WOMEN
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- 10.1016/j.artres.2010.10.076How to use a DOI?
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Purpose: During normal pregnancy (NP), the cardiovascular system adapts to the metabolic needs of mother and foetus with increased cardiac output (CO) and reduced vascular resistance. In NP blood pressure is not increased despite an increase of CO due to vasodilation of the resistance vessels. It is unknown whether this is also modulated by changes in the properties of the large arteries.
Methods: 65 (33±1 years) with NP were investigated at gestational weeks 14–16, 22–24, 36 and 6 months postpartum (PP). Aortic root pressure and flow were obtained by calibrated right subclavian artery pulse trace, and aortic annular Doppler flow recordings. Systemic arterial properties were described by total arterial compliance(C), arterial elastance (Ea), characteristic impedance (Z0), and peripheral arterial resistance (R). Wave reflection was assessed as the ratio of the magnitude of the backward (Pb) to forward (Pf) pressure wave. Parameters were estimated by Fourier analysis of central aortic pressure and flow data and methods based on the 2-element windkessel model.
Results: (Table) During NP, CO increased due to increased heart rate and stroke volume, whereas, blood pressures were lower as compared to 6 months PP. R was significantly reduced accompanied by a marginally lowered Ea and Z0, whereas C was unchanged. The forward and backward pressure wave-amplitudes were significantly reduced, and reflection magnitude trended lower in mid to late pregnancy.
Conclusions: During NP profound alterations of systemic hemodynamics occur, with increased cardiac output and reduced blood pressures, where the latter is related mainly to reduction in peripheral arterial resistance.
| 14–16 weeks | 22–24 weeks | 36 weeks | 6 months PP | ANOVA P | |
|---|---|---|---|---|---|
| Mean arterial pressure (mmHg) | 82.8 ± 6.6 | 80.0 ± 6.2# | 84.8 ± 7.1#¤ | 88.0 ± 7.3¤ | <0.001 |
| Heart rate (min−1) | 71 ± 7 | 74 ± 8# | 77 ± 10#¤ | 66 ± 7 #¤§ | <0.001 |
| Cardiac output (l min−1) | 6.1 ± 1.1 | 6.1 ± 1.1 | 5.8 ± 1.0 | 4.9 ± 0.9 #¤§ | <0.001 |
| R (mmHg ml−1 s−1) | 0.85 ± 0.18 | 0.81 ± 0.16 | 0.92 ± 0.23¤ | 1.10 ± 0.29#¤§ | <0.001 |
| Z0 (10־3mmHg ml−1 s−1) | 43 ± 18 | 51 ± 36 | 45 ± 23 | 55 ± 21 | 0.168 |
| C WK (ml mmHg−1) | 1.45 ± 0.33 | 1.56 ± 0.45 | 1.55 ± 0.46 | 1.40 ± 0.45 | 0.220 |
| C PPM (ml mmHg−1) | 1.25 ± 0.26 | 1.23 ± 0.28 | 1.22 ± 0.33 | 1.14 ± 0.30 | 0.454 |
| Ea (mmHg ml−1) | 1.0 ± 0.25 | 1.02 ± 0.24 | 1.19 ± 0.28¤ | 1.27 ± 0.28#¤ | <0.001 |
| Amplitude Forward Wave (Pf; mmHg) | 31 ± 6 | 30 ± 9 | 28 ± 5# | 30 ± 6 | 0.013 |
| Amplitude Backward Wave (Pb; mmHg) | 20 ± 3 | 17 ± 4# | 17 ± 4# | 19 ± 4§ | <0.001 |
| Reflection magnitude (Pb/Pf) | 0.64 ± 0.13 | 0.59 ± 0.15 | 0.61 ± 0.13 | 0.64 ± 0.13 | 0.051 |
Mean ± SD. p< 0.05 vs
14–16 w,
22–24 w,
36 w. WK = C obtained using windkessel model fit; PPM= pulse pressure method.
Cite this article
TY - JOUR AU - M.E. Estensen AU - E.W. Remme AU - A. Swillens AU - T. Henriksen AU - O.A. Smiseth AU - L. Gullestad AU - P. Segers AU - S. Aakhus PY - 2010 DA - 2010/12/02 TI - P6.06 SYSTEMIC ARTERIAL PROPERTIES DURING NORMAL PREGNANCIES IN HEALTHY WOMEN JO - Artery Research SP - 167 EP - 167 VL - 4 IS - 4 SN - 1876-4401 UR - https://doi.org/10.1016/j.artres.2010.10.076 DO - 10.1016/j.artres.2010.10.076 ID - Estensen2010 ER -