Echocardiographic and blood parameters in 51 women with uncomplicated singleton pregnancies
| First trimester | Second trimester | Third trimester | PP1 | PP2 | |
| Clinical data | |||||
| Maternal body weight, kg | 53.8 (7.8) | 58.3 (8.0)* | 62.1 (8.1)* | 59.3 (8.1)* | 56.1 (7.7) |
| Heart rate, beats/min | 74 (10) | 81 (10)* | 84 (13)* | 76 (10) | 69 (10) |
| Systolic blood pressure, mm Hg | 111 (13) | 106 (12) | 110 (12) | 109 (11) | 115 (11) |
| Diastolic blood pressure, mm Hg | 66 (9) | 62 (7) | 66 (9) | 64 (9) | 70 (10) |
| Weight gain in pregnancy, kg | 0.5 (1.7) | 5.1 (3.0)* | 8.9 (4.2)* | 6.0 (4.1)* | 2.8 (3.4)* |
| Weight gain, % | 1.0 (3.2) | 9.8 (5.7)* | 17.2 (8.0)* | 11.8 (7.9)* | 5.7 (6.1)* |
| BSA gain, % | 0.4 (1.4) | 4.0 (2.3)* | 6.9 (3.2)* | 4.8 (3.2)* | 2.3 (2.5)* |
| Echocardiographic parameters | |||||
| LVDd, mm | 44.4 (3.3) | 45.5 (3.3) | 45.8 (3.3) | 46.6 (3.4)* | 45.0 (3.3) |
| LVDs, mm | 29.1 (2.4) | 29.5 (2.2) | 30.4 (2.8)* | 30.9 (2.7)* | 30.1 (2.5) |
| Shortening fraction, % | 34.3 (3.1) | 35.2 (3.0) | 33.6 (3.6) | 33.7 (3.6) | 33.1 (3.0) |
| LVEF, % | 63.9 (3.8) | 64.3 (4.1) | 62.4 (4.8) | 62.7 (4.5) | 61.9 (3.9) |
| Interventricular septum thickness, mm | 6.8 (0.9) | 7.4 (0.9)* | 7.9 (1.0)* | 8.0 (1.0)* | 7.5 (1.0)* |
| LV posterior wall thickness, mm | 6.3 (0.7) | 6.8 (0.7)* | 7.5 (1.0)* | 7.5 (1.1)* | 6.9 (1.0)* |
| LV mass, g | 86.4 (16.5) | 100.0 (20.4)* | 111.5 (22.4)* | 116.6 (25.1)* | 101.4 (24.8)* |
| LV mass/BSA, g/m2 | 55.9 (9.0) | 62.4 (10.6)* | 67.9 (12.7)* | 72.3 (13.9)* | 64.3 (13.9)* |
| Aortic diameter at sinus of Valsalva, mm | 27.5 (1.9) | 28.0 (1.9) | 28.7 (1.7)* | 28.8 (2.0)* | 28.5 (2.1)* |
| LA diameter PLAX, mm | 28.5 (3.5) | 31.3 (3.5)* | 31.7 (3.7)* | 33.7 (3.7)* | 30.0 (3.5) |
| Maximum LA volume, mL | 31.8 (9.9) | 36.4 (9.1) | 40.2 (10.0)* | 45.4 (11.8)* | 35.3 (9.1) |
| Maximum LA volume/BSA, mL/m2 | 20.5 (5.9) | 22.8 (5.2) | 24.4 (5.7)* | 28.1 (6.5)* | 22.4 (5.0) |
| Pulmonary arterial diastolic pressure, mm Hg | 7.8 (0.7) | 7.9 (0.8) | 8.2 (0.8) | 8.1 (0.9) | 7.9 (1.0) |
| IVC diameter, mm | 14.0 (4.7) | 13.2 (3.3) | 10.8 (2.9)* | 17.6 (4.4)* | 15.8 (4.0) |
| Stroke volume, mL | 65.6 (8.7) | 66.3 (8.8) | 64.3 (10.1) | 74.3 (8.7)* | 65.7 (8.2) |
| Stroke volume/BSA, mL/m2 | 42.2 (5.2) | 41.6 (4.4) | 39.1 (5.5)* | 46.2 (4.8)* | 41.9 (4.7) |
| Cardiac output, L/min | 4.8 (0.7) | 5.3 (0.7)* | 5.3 (1.0)* | 5.7 (0.9)* | 4.5 (0.7) |
| Cardiac index, L/min/m2 | 3.1 (0.5) | 3.3 (0.4) | 3.2 (0.6) | 3.5 (0.6)* | 2.9 (0.4) |
| Systemic vascular resistance, dyn· s/cm5 | 1295 (241) | 1081 (144)* | 1174 (245) | 1067 (209)* | 1445 (246)* |
| Mitral inflow parameters | |||||
| E, cm/s | 78 (17) | 70 (15) | 65 (17)* | 86 (16) | 69 (16)* |
| A, cm/s | 49 (12) | 53 (11) | 56 (11)* | 60 (12)* | 51 (12) |
| E/A | 1.7 (0.5) | 1.4 (0.4)* | 1.2 (0.4)* | 1.5 (0.4) | 1.4 (0.5)* |
| Dct, ms | 180 (31) | 176 (24) | 168 (29) | 167 (24)* | 187 (24) |
| Pulmonary vein inflow parameters | |||||
| S, cm/s | 45 (10) | 49 (11) | 49 (10) | 55 (13)* | 44 (12) |
| D, cm/s | 52 (10) | 47 (10) | 46 (11)* | 53 (12) | 47 (11)* |
| S/D | 0.9 (0.2) | 1.1 (0.3)* | 1.1 (0.3)* | 1.1 (0.3)* | 1.0 (0.3) |
| TDI mitral annulus | |||||
| Septal | |||||
| s′ sept, cm/s | 9.1 (1.6) | 10.0 (1.4)* | 9.9 (2.0) | 9.5 (1.6) | 8.4 (1.4) |
| e′ sept, cm/s | 13.1 (2.0) | 13.3 (2.8) | 11.5 (2.6)* | 12.2 (2.4) | 10.9 (2.4)* |
| a′ sept, cm/s | 9.5 (1.9) | 10.0 (1.6) | 10.8 (2.4)* | 10.7 (2.7)* | 9.3 (2.0) |
| Lateral | |||||
| s′ lat, cm/s | 11.9 (2.3) | 12.9 (2.9) | 12.2 (2.9) | 11.4 (2.0) | 11.5 (2.4) |
| e′ lat, cm/s | 16.9 (2.8) | 16.8 (2.5) | 15.3 (2.3)* | 16.2 (2.8) | 15.3 (2.9)* |
| a′ lat, cm/s | 8.8 (1.8) | 10.1 (2.0)* | 10.2 (2.1)* | 10.8 (2.4)* | 9.3 (2.1) |
| Average | |||||
| s′ ave, cm/s | 10.5 (1.8) | 11.5 (2.0)* | 11.1 (2.2) | 10.5 (1.6) | 10.0 (1.7) |
| e′ ave (e’), cm/s | 15.0 (2.1) | 15.1 (2.2) | 13.4 (2.2)* | 14.2 (2.2) | 13.2 (2.4)* |
| a′ ave, cm/s | 9.2 (1.6) | 10.1 (1.6) | 10.5 (1.9)* | 10.7 (2.4)* | 9.3 (1.8) |
| E/e′ average (E/e’) | 5.3 (1.0) | 4.8 (1.2) | 5.0 (1.4) | 6.2 (1.2)* | 5.3 (1.0) |
| Blood data | |||||
| hs-TnI, pg/mL | 0.8 (0.1–3.5) | 0.9 (0.1–2.6) | 1.3 (0.3–3.8)* | 2.3 (0.7–8.8)* | 1.2 (0.5–3.0)* |
| NT-proBNP, pg/mL | 43 (11–180) | 28 (8–85)* | 24 (6–122)* | 127 (22–396)* | 31 (10–93)* |
| BNP, pg/mL | 10.4 (2.9–33.8) | 8.0 (2.9–24.6)* | 7.9 (2.1–27.3)* | 32.0 (4.3–109)* | 7.9 (1.7–26.3) |
| CK-MB, ng/mL | 0.4 (0.2–1.1) | 0.6 (0.2–3.5)* | 0.7 (0.2–2.8)* | 1.2 (0.5–5.5)* | 0.7 (0.3–2.7)* |
| eGFR, mL/min/1.73 m2 | 123 (93–163) | 121 (89–167) | 110 (84–148) | 101 (73–141)* | 88 (64–130)* |
Clinical and echocardiographic data are presented as means (SD). Blood data are presented as medians (fifth – 95th).
*P<0.05 vs baseline value determined in the first trimester of pregnancy. BNP levels were determined in a limited number of women; the numbers of women tested at the first, second, and third trimesters, PP1 and PP2 were 51, 47, 42, 41 and 43 for BNP, respectively.
A, late diastolic mitral flow velocity; a′ ave, average of late diastolic septal and lateral mitral annular velocity; a′ lat, late diastolic lateral mitral annular velocity; a′ sept, late diastolic septal mitral annular velocity; BNP, brain natriuretic peptide; BSA, body surface area; CK-MB, creatine kinase MB; D, anterograde diastolic pulmonary venous flow velocity; Dct, deceleration time of early diastolic mitral flow velocity; E, early diastolic mitral flow velocity; e′ ave, average of early diastolic septal and lateral mitral annular velocity; e′ lat, early diastolic lateral mitral annular velocity; e′ sept, early diastolic septal mitral annular velocity; eGFR, estimated glomerular filtration rate; hs-TnI, high-sensitivity troponin I; IVC, inferior vena cava; LA, left atrium; LV, left ventricle; LVEF, LV ejection fraction; LVDd, LV end-diastolic dimension; LVDs, LV end-systolic dimension; NT-proBNP, N-terminal pro b-type natriuretic peptide; PLAX, from parasternal long-axis view; PP1 and PP2, postpartum day 2–6 and 24–39, respectively; S, systolic pulmonary venous flow velocity; s′ ave, average of systolic septal and lateral mitral annular velocity; s′ lat, systolic lateral mitral annular velocity; s′ sept, systolic septal mitral annular velocity; TDI, tissue Doppler imaging.