Cardiovascular function before, during, and after the first and subsequent pregnancies

被引:344
作者
Clapp, JF
Capeless, E
机构
[1] CASE WESTERN RESERVE UNIV, DEPT REPROD BIOL, CLEVELAND, OH 44106 USA
[2] CASE WESTERN RESERVE UNIV, DEPT OBSTET & GYNECOL, CLEVELAND, OH 44106 USA
[3] UNIV VERMONT, COLL MED, DEPT OBSTET & GYNECOL, BURLINGTON, VT 05405 USA
关键词
D O I
10.1016/S0002-9149(97)00738-8
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
This study was designed to test the hypothesis that the vascular remodeling of pregnancy begins early, persists for at least 1 year after delivery, and is accentuated by a second pregnancy, Serial estimates of heart rate, arterial pressure, left ventricular volumes, cardiac output, and calculated peripheral resistance were obtained before pregnancy, every 8 weeks during pregnancy, and 12, 24, and 52 weeks postpartum in 15 nulliparous and 15 porous women using electrocardiography, automated manometry, and M-mode ultrasound, During pregnancy, body weight increased 14.5 +/- 1.8 kg and returned to prepregnancy values 1 year postpartum, Heart rate peaked at term 15 +/- 1 beat/min above prepregnancy levels (57 +/- 1 beat/min), Mean arterial pressure reached its nadir (-6 +/- 1 mm Hg) at 16 weeks, returning to baseline at term, The increases in left ventricular volumes and cardiac output (2.2 +/- 0.2 L/min) peaked at 24 weeks as did the 500 +/- 29 dynes.cm.s(-5) decrease in peripheral resistance, and their magnitude was significantly greater in the parous women, Postpartum they gradually returned toward baseline but remained significantly different from prepregnancy values in both groups at 1 year, We conclude that cardiovascular adaptations to the initial pregnancy begin early, persist postpartum, and appear to be enhanced by a subsequent pregnancy, We speculate that persistence of these changes may lower cardiovascular risk in later life. (C) 1997 by Excerpta Medica, Inc.
引用
收藏
页码:1469 / 1473
页数:5
相关论文
共 30 条
  • [21] LEFT-VENTRICULAR SIZE, OUTPUT, AND STRUCTURE DURING GUINEA-PIG PREGNANCY
    MORTON, M
    TSANG, H
    HOHIMER, R
    ROSS, D
    THORNBURG, K
    FABER, J
    METCALFE, J
    [J]. AMERICAN JOURNAL OF PHYSIOLOGY, 1984, 246 (01): : R40 - R48
  • [22] REPRODUCTIVE HISTORY AND CORONARY HEART-DISEASE RISK IN WOMEN
    NESS, RB
    SCHOTLAND, HM
    FLEGAL, KM
    SHOFER, FS
    [J]. EPIDEMIOLOGIC REVIEWS, 1994, 16 (02) : 298 - 314
  • [23] CARDIOVASCULAR-RESPONSES TO CIRCULATING CATECHOLAMINES IN NORMAL-PREGNANCY AND IN PREGNANCY-INDUCED HYPERTENSION
    NISELL, H
    HJEMDAHL, P
    LINDE, B
    [J]. CLINICAL PHYSIOLOGY, 1985, 5 (05): : 479 - 493
  • [24] HEMODYNAMIC-CHANGES DURING THE PUERPERIUM - A DOPPLER AND M-MODE ECHOCARDIOGRAPHIC STUDY
    ROBSON, SC
    HUNTER, S
    MOORE, M
    DUNLOP, W
    [J]. BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 1987, 94 (11): : 1028 - 1039
  • [25] SERIAL STUDY OF FACTORS INFLUENCING CHANGES IN CARDIAC-OUTPUT DURING HUMAN-PREGNANCY
    ROBSON, SC
    HUNTER, S
    BOYS, RJ
    DUNLOP, W
    [J]. AMERICAN JOURNAL OF PHYSIOLOGY, 1989, 256 (04): : H1060 - H1065
  • [26] CARDIAC SIZE AND PERFORMANCE DURING PREGNANCY ESTIMATED WITH ECHOCARDIOGRAPHY
    RUBLER, S
    DAMANI, PM
    PINTO, ER
    [J]. AMERICAN JOURNAL OF CARDIOLOGY, 1977, 40 (04) : 534 - 540
  • [27] SABN DJ, 1978, CIRCULATION, V58, P1072
  • [28] Long-term effects of multiple pregnancies on cardiac dimensions and systolic and diastolic function
    Sadaniantz, A
    Laurent, LS
    Parisi, AF
    [J]. AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1996, 174 (03) : 1061 - 1064
  • [29] PROBLEMS IN ECHOCARDIOGRAPHIC VOLUME DETERMINATIONS - ECHOCARDIOGRAPHIC-ANGIOGRAPHIC CORRELATIONS IN PRESENCE OR ABSENCE OF ASYNERGY
    TEICHHOLZ, LE
    KREULEN, T
    HERMAN, MV
    GORLIN, R
    [J]. AMERICAN JOURNAL OF CARDIOLOGY, 1976, 37 (01) : 7 - 11
  • [30] ESTRADIOL AND HEMODYNAMICS DURING OVULATION INDUCTION
    VEILLE, JC
    MORTON, MJ
    BURRY, K
    NEMETH, M
    SPEROFF, L
    [J]. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1986, 63 (03) : 721 - 724