Background: While the hemodynamic changes occurring during pregnancy have been reasonably well characterized, the impact of pregnancy on cardiac contractile function has not been fully elucidated.
Objective: To assess myocardial left ventricular functions in normal pregnant females using 2D speckle tracking echocardiography in comparison to non-pregnant adult females.
Patient and methods: The study was a prospective observational study that was carried out at Cardiology Department, Al-Azhar University Hospitals throughout the period between August 2016 and July 2019. The study involved 15 healthy control unpregnant women in addition to 45 pregnant ladies (15 in each trimester). All the included subjects underwent thorough clinical examination, routine laboratory investigations, resting electrocardiogram (ECG), resting conventional trans-thoracic echocardiography, and speckle tracking echocardiography.
Results: The two groups showed no-significant difference between them in accordance with age, systolic, and diastolic blood pressure. Left ventricular (LV) internal dimensions at end diastole (LVEDD) had significantly higher values in the third trimester cases. Moreover, the control group had the lowest value among the study groups. No significant changes were detected in LVESD. LVEDV and LVESV showed a significant increase during pregnancy. All readings were significantly higher than controls. The two groups showed no significant difference between them in accordance with ejection fraction. Global longitudinal strain was significantly different between the study groups. It decreases from 20.73% in the first trimester down to 18.33 and 16.67% in the second and third trimesters respectively. Besides, two-, three-, and four-chamber strain showed the same changes as well.
Conclusion: Cardiac adaptation throughout normal pregnancy is characterized by LV longitudinal thickening reduction.