The Effect of Gestational Hypertension on Left Ventricular Geometry

Heart rate, stroke volume, cardiac output and left ventricular mass increase during pregnancy while peripheral vascular resistance decreases. Gestational hypertension (GHT) which is noted in some pregnancies during the third trimester is considered as a temporary condition. Its effects on left ventricular geometry (LVG) is not known. In this study we aimed to assess the effects of this acute pressure overload in GHT on the LVG. Forty-three pregnant women (mean age 28.7±8.9 years) with gestational hypertension were included in the study (Group A). Blood pressure levels over >140/90 mmHg were considered as GHT in this group. Fifty-six pregnant women (mean age 25.7±5.7 years) with normal blood pressures formed the control group (Group B). Transthoracic echocardiographic evaluation was performed at left lateral decubital position for all women before delivery. Left ventricle (LV) end-systolic (ES) and end-diastolic (ED) diameters, LV septal and posterior wall thickness were measured and LV mass index (MI) and relative wall thickness (RWT) were calculated using Devereux and Ganau formulas. LVG was defined as normal (N), concentric hypertrophic (CH), eccentric hypertrophic (EH) and concentric remodeling (CR). LVMI and RWT were 138±13.8 g/m2 and 0.46±0.09 and 117±15 g/m2 and 0.4±0.03 in Group A and Group B, respectively (p=0.01, p=0.03). LVG was %38.9 N, %19.4 EH, %14 CH, %27.7 CR in hypertensive pregnants and was %78.6 N, %7 EH, %5.4 CH, %9 CR in normotensive pregnants (p<0.001). These findings suggest that LVMI and RWT are greater in GHT compared to normotensive pregnants. Abnormal geometric pattern most frequently observed are eccentric hypertrophy and concentric remodeling