Cited by 7Cardiovascular Issues in PregnancyCardiac Valve Diseases and TreatmentsCongenital Heart Disease Studies

Pregnancy related changes in Doppler gradients and left ventricular mechanics in women with sub-valvular or valvular aortic stenosis

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Chang, Soohyun A., Khakh, Parm, Janzen, Mikyla, Kiess, Marla, Rychel, Valerie, Grewal, Jasmine·2021·Echocardiography

Abstract

Abstract Background The aim of our study was to characterize echocardiographic changes during pregnancy in women with known LVOT obstruction or AS compared to the healthy pregnancy controls, and to assess the relationship with pregnancy outcomes. Methods We retrospectively studied 34 pregnant patients with congenital LVOT obstruction or AS with healthy age‐matched pregnant controls. Patients with other significant valvular lesions, structural heart disease (LVEF < 40%), or prior valve surgery were excluded. All LVOTO/AS patients underwent a minimum of two consecutive echocardiograms between 1 year pre‐conception and 1 year postpartum, with at least two studies during the pregnancy. Comprehensive echocardiographic evaluation was performed including speckle‐tracking LV global longitudinal strain. Results A total of 83 echocardiograms from the study group and 34 echocardiograms from the control group were evaluated. Over the range of LVOTO/AS, a significantly greater increase in the AV gradients and LV and LA volumes were observed as compared with the controls. In the sub‐group of LVOTO/AS pregnant women with ≥ moderate (n = 8) versus < moderate LVOTO/AS (n = 26), averaged 2nd/3rd trimester LVEF was lower (51 ± 12)% versus (58 ± 4)%, (p = 0.02) and GLS was lower (−19.5 ± 2.8) versus (21.2 ± 2.4), (p = 0.06). Pregnancy was well tolerated despite these changes. Conclusion Among pregnant women with even milder forms of LVOTO/AS, increases in cardiac volumes and AV gradients can be expected over the course of pregnancy. Significant decreases in LV function and mechanics were only observed in women with moderate or greater LVOTO/AS, although still remained in normal range.

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Crossref · 10.1111/echo.15208

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Authors
Chang, S. A., Khakh, P., Janzen, M., Kiess, M., Rychel, V., & Grewal, J.
Affiliations
University of British Columbia (CA)
Corresponding author
Grewal, Jasmine
Venue
Echocardiography
Publisher
Wiley
Published
2021-10
Volume
38
Issue
10
Pages
1754-1761
ISSN
  • 0742-2822 (ISSN-L)
  • 1540-8175
OpenAlex
W3173367972
Cited by
7
References
39
Citations by year
2026: 2 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 1
FWCI
0.67
Type
journal article
Language
en
Open access
Locations
  • Echocardiography (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Issues in Pregnancy
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
  • Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
Keywords
pregnancy, aortic stenosis, subaortic stenosis, left ventricular outflow tract obstruction, Doppler gradient, left ventricular mechanics, left ventricular ejection fraction, global longitudinal strain, left atrial volume, left ventricular volume, pregnancy outcomes
MeSH terms
Aortic Valve Stenosis, Echocardiography, Female, Heart Ventricles, Humans, Pregnancy, Retrospective Studies

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