Reversible De Novo Left Ventricular Trabeculations in Pregnant Women Implications for the Diagnosis of Left Ventricular Noncompaction in Low-Risk Populations
Reversible De Novo Left Ventricular Trabeculations in Pregnant Women Implications for the Diagnosis of Left Ventricular Noncompaction in Low-Risk Populations
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DOI：
10.1161/circulationaha.114.008554
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发表时间：
2014-08-05
期刊：
影响因子：
37.8
通讯作者：
Sharma, Sanjay
中科院分区：
文献类型：
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作者：
Gati, Sabiha;Papadakis, Michael;Sharma, Sanjay
心力衰竭和慢性贫血患者常表现为左心室（LV）小梁，这可能与LV致密化不全的诊断一致。我们使用的妊娠模型，其特点是心脏前负荷和心脏功能的其他变化的可逆性增加，以评估发展的从头LV小梁的妇女形态normalizedhearts.Methods和Results-One的102个pregnancy孕妇进行了纵向评估，在第一个三个月，在第三个三个月，产后一系列的超声心动图。根据既定指南分析超声心动图。LV小梁增加和LV致密化不全的存在基于既定标准。妊娠与心率、每搏输出量和心输出量增加以及左室容积和质量增加相关。在怀孕期间，26名妇女（25.4%）的小梁增加。8名女性表现出足够的小梁，以满足标准的左心室致密化不全。在产后随访期间的24 +/- 3个月，19名妇女（73%）表现出完全解决的小梁，和5个表现出显着的减少在trabeculated layer. Conclusions妊娠诱导从头左室小梁在一个显着的比例的妇女。结果表明，LV小梁形成是对LV负荷增加或妊娠的其他生理反应的反应，而不是LV致密化不全的特异性反应。这些因素应考虑在评估个人与左室小梁以外的背景下的症状，心力衰竭或家族性心肌病。
Background-Patients with heart failure and chronic anemia frequently demonstrate left ventricular (LV) trabeculations, which may be compatible with the diagnosis of LV noncompaction. We used the pregnancy model, which is characterized by a reversible increase in cardiac preload and other changes in cardiac function, to assess the development of de novo LV trabeculations in women with morphologically normal hearts.Methods and Results-One hundred two primigravida pregnant women were evaluated longitudinally with a series of echocardiograms in the first trimester, in the third trimester, and postpartum. Echocardiograms were analyzed according to established guidelines. Increased LV trabeculations and the presence of LV noncompaction were based on established criteria. Pregnancy was associated with an increased heart rate, stroke volume, and cardiac output, as well as increased LV volume and mass. During pregnancy, 26 women (25.4%) developed increased trabeculations. Eight women showed sufficient trabeculations to fulfill criteria for LV noncompaction. During the postpartum follow-up period of 24 +/- 3 months, 19 women (73%) demonstrated complete resolution of trabeculations, and 5 showed a marked reduction in the trabeculated layer.Conclusions-Pregnancy induces de novo LV trabeculations in a significant proportion of women. The results suggest that LV trabeculations occur in response to increased LV loading conditions or other physiological responses to pregnancy and are not specific for LV noncompaction. These factors should be considered in the assessment of individuals with LV trabeculations outside the context of symptoms of heart failure or familial cardiomyopathy.