Analysis of Myocardial Left Ventricular Deformation During the Third Trimester of Healthy Pregnancy

Abstract

Background: Pregnancy, a distinctive physiologic state, that associated with multiple changes in the several body systems. One of the affected systems is cardiovascular system , with volume overload being one of the typical adaptation encountered during pregnancy, with chronic volume overload being one of the characteristic changes experienced during pregnancy. However, the effect of these changes on left ventricular myocardial contractile function has not been fully illustrated. Aim: To assess the maternal cardiac function during the third trimester of healthy pregnancy using Speckle Tracking echocardiography. Patient and Methods: This cross sectional study was carried out in Al-Furat teaching hospital in the time period from 1st of April 2022 to 30 of May 2023. A total of 150 women were studied, they were classified into two groups: 75 pregnant women with normal singleton pregnancy at their third trimester served as study group and 75 non pregnant women served as control group. Clinical evaluation, anthropometric assessments, and two-dimensional M-mode and Doppler echocardiography as well as Speckle Tracking echocardiographic study had been done for each one of them to assess the left ventricular systolic function. Results: The two groups showed significant difference in accordance with weight , height & BMI. Global longitudinal strain (GLS) was significantly different between the study groups . Its Average value was decrease to -20.3 compared with -25.3 in control group. Besides, apical long-axis , three-, and four-chamber strain showed significant changes as well. With lowest strain value was the apical long-axes -18.96 in comparison with the control. Conclusion: Left ventricular global longitudinal strain (GLS) shows significant reduction during the third trimester of healthy pregnancy ,this reduction in LV thickening is one of the cardiac adaptation throughout the pregnancy.