PP.24.07

Abstract

Objective: Alteration of diastolic function including left atrial volume (LAV), left ventricular mass (LVM) and E/E’ considered a sensitive means for detecting changes in the normal cardiac adaptation to pregnancy. However, only a few study have assessed the influence of dipping pattern of nocturnal blood pressure on diastolic function in pregnancy. The aim of this study is to know the association between dipping pattern of nocturnal blood pressure and diastolic function in pregnancy. Design and method: We analyzed the results of 24 hour ambulatory blood pressure monitoring (ABPM) and echocardiography of 125 women with pregnancy. All of the tests were done in late third trimester of pregnancy. We exclude the pregnant patients with antihypertensive medication or past history of hypertension. Degree of night BP reduction was calculated as (1- (Mean SBP in night time/Mean SBP in day time) x 100. Results: The mean gestational age at the time of test was 29 ± 3 weeks. Mean blood pressure of 24 hour ABPM was 123.4 ± 16.5 / 84.5 ± 11.2 mmHg (day time mean: 126.3 ± 18.3/84.1 ± 9.8 mmHg, night time mean: 117.5 ± 15.7/75.6 ± 7.9 mmHg). Mean degree of night time blood pressure reduction was 8.8 ± 6.1. In echocardiography, mean left ventricular ejection fraction and E/E’ was 61.8 ± 10.1% and 8.9 ± 3.9, respectively. In addition, mean LAV index and LVM index were 29.3 ± 10.1 mL/m2 and 114.9 ± 22.5 g/ m2. Mean deceleration time (DT) was 192.4 ± 31.2 ms. Regarding to the relation between nocturnal blood pressure and diastolic function, LVM index was not correlated with degree of nocturnal blood pressure reduction, However, E/E’ was negatively correlated with degree of nocturnal blood pressure reduction(r = -0.257, p = 0.004). In addition, LAV index showed negative correlation with degree of nocturnal blood pressure reduction (r = -0.637, p < 0.001). Conclusions: In late third trimester of pregnancy, abnormal dipping pattern of nocturnal blood pressure might be associated with enlargement of LAV