Left ventricular rotational characteristics in healthy mid-term pregnancy—insights from the three-dimensional speckle-tracking echocardiographic MAGYAR-Preg Study

Abstract

Background Haemodynamic, neurohormonal, plasma volume, haematological, and structural cardiac changes occur during healthy pregnancy to varying degrees depending on the trimester. The aim of the present observational cross-sectional study was to compare left ventricle (LV) rotational mechanics in healthy pregnant subjects with those of age-matched non-pregnant women using three-dimensional speckle-tracking echocardiography (3DSTE). Methods The initial study population consisted of 27 healthy subjects in mid-term pregnancy; however, 6 cases were excluded due to suboptimal image quality. Consequently, the final analytical cohort comprised 21 subjects (mean age: 30.7±2.7 years). This group was compared to a control group of 27 age-matched healthy non-pregnant volunteers (mean age: 28.4±6.0 years). Results In three pregnant subjects, the near absence of LV rotational mechanics, referred to as rigid body rotation (RBR), was observed (3 of 21, 14%) with counterclockwise orientation. The remaining 18 subjects showed normally directed LV rotational mechanics (18 of 21, 86%). A significant reduction in apical LV rotation (4.0±3.9° vs. 9.2±3.2°, P<0.05) and LV twist (6.8±3.6° vs. 13.1±3.4°, P<0.05) could be detected in healthy pregnant women compared with non-pregnant subjects. Basal LV rotation did not differ significantly between the two groups (−3.2±2.3° vs. −3.8±1.8°, P=ns). Time to peak apical LV twist tended to be shorter in pregnant women; however, this difference did not reach statistical significance. Conclusions Reduced apical LV rotation and consequent LV twist with preserved basal LV rotation could be detected in healthy mid-term pregnancy. In some cases, counterclockwise LV-RBR was observed.