Venous and arterial behavior during normal pregnancy
Venous and arterial behavior during normal pregnancy
复制标题
DOI：
10.1152/ajpheart.1998.274.5.h1605
复制
发表时间：
1998-05-01
影响因子：
4.8
通讯作者：
Safar, ME
中科院分区：
文献类型：
--
作者：
Edouard, DA;Pannier, BM;Safar, ME
为了评估动脉和静脉系统在正常妊娠血流动力学变化中的作用，我们研究了9名健康女性的血流、血管阻力、静脉张力和上下肢的粘弹性（“蠕变”）（使用体积描记法）、主动脉扩张性（使用脉搏波速度测量）和心脏尺寸（使用超声心动图）。纵向研究进行了比较，在第一（10-13周）和第三（33-38周）妊娠期与分娩后的第三个月和第六个月之间的时期。从孕早期开始，心率明显增加，而体循环血压和肢体血管阻力无明显变化，主动脉扩张性增加（P < 0.05）。下肢粘弹性在孕晚期降低（P < 0.05），静脉张力较孕早期升高（P < 0.01），而上肢部位变化不大。在妊娠早期（P < 0.001）和妊娠晚期（P < 0.05），小腿静脉张力的降低与左室舒张期内径的增加显著相关。该研究提供的证据表明，在正常妊娠期间，循环的动脉和静脉侧的变化独立于压力变化而发生。静脉张力的增加有助于前负荷增加，而主动脉僵硬度的降低则减少了后负荷，这两种情况都优化了分娩前的心脏功能。
To assess the contribution of the arterial and venous systems in the hemodynamic changes of normal pregnancy, we studied blood flow, vascular resistance, venous tone, and the viscoelastic properties ("creep") of the upper and lower limbs (using plethysmography), aortic distensibility (using pulse wave velocity measurements), and cardiac dimensions (using echocardiography) in nine healthy women. Studies were longitudinally performed at the first (10-13 wk) and third (33-38 wk) trimesters of pregnancy in comparison with the period between the third and sixth month after delivery. From the first trimester, heart rate significantly increased while systemic blood pressure and limb vascular resistances did not change significantly and aortic distensibility increased (P < 0.05). Lower limb viscoelastic properties decreased at the third trimester (P < 0.05) and venous tone increased from the first trimester (P < 0.01), whereas little changes were observed at the site of upper limbs. The decrease in calf venous tone was significantly correlated with the increase in left ventricular diastolic diameter at the first (P < 0.001) and the third trimester (P < 0.05). The study provides evidence that during normal pregnancy, changes in the arterial and venous sides of the circulation occur independently of pressure alterations. The increase in venous tone, contributing to preload augmentation, and the decrease in aortic stiffness, reducing afterload, both optimize cardiac function until delivery.